Provider Demographics
NPI: | 1154662534 |
---|---|
Name: | HEALTH ASSURANCE, INC |
Entity type: | Organization |
Organization Name: | HEALTH ASSURANCE, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MEDICAL DIRECTOR/PRACTITIONER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | DANA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | COWLES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 407-257-5457 |
Mailing Address - Street 1: | 1856 ALAQUA DR |
Mailing Address - Street 2: | |
Mailing Address - City: | LONGWOOD |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32779-3103 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 855-634-2432 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1855 W SR 434 |
Practice Address - Street 2: | SUITE #233 |
Practice Address - City: | LONGWOOD |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32750-5069 |
Practice Address - Country: | US |
Practice Address - Phone: | 855-634-2432 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-03-08 |
Last Update Date: | 2013-03-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | OS9752 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |