Provider Demographics
NPI:1336410232
Name:BOWEN, JERMAINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JERMAINE
Middle Name:
Last Name:BOWEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16411 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5209
Mailing Address - Country:US
Mailing Address - Phone:954-324-7447
Mailing Address - Fax:954-342-1820
Practice Address - Street 1:16 NW 26TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5106
Practice Address - Country:US
Practice Address - Phone:305-642-5600
Practice Address - Fax:305-642-5699
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39268183500000X
FLPU65121835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist