Provider Demographics
NPI:1427443225
Name:STOWE, ASHLEY MICHELLE (OD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MICHELLE
Last Name:STOWE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4216 HERSCHEL ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-2208
Mailing Address - Country:US
Mailing Address - Phone:904-479-2020
Mailing Address - Fax:904-474-0477
Practice Address - Street 1:4216 HERSCHEL ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2208
Practice Address - Country:US
Practice Address - Phone:904-479-2020
Practice Address - Fax:904-474-0477
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5049152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOPC 5049OtherSTATE LICENSE