Provider Demographics
NPI:1154607018
Name:FOWLES, SARAH MAE (DO)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MAE
Last Name:FOWLES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:MAR
Other - Last Name:DUQUETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10763 SE BURGEE VT
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455
Mailing Address - Country:US
Mailing Address - Phone:321-217-9847
Mailing Address - Fax:
Practice Address - Street 1:1800 SE TIFFANY AVE
Practice Address - Street 2:ST LUCIE MEDICAL CENTER
Practice Address - City:ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953
Practice Address - Country:US
Practice Address - Phone:772-335-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOU2593207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine