| Doctor Name: | DR. JIMMY ALLEN BOWMAN |
| NPI Number: | 1003121542 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 12232 |
| Business Practice Address: | 888 Us Highway 1 Rockledge, FL - 329552126 |
| Business Phone Number: | 3216313155 |
| Business Fax Number: | 3216388684 |
| Mailing Address: | 950 N Courtenay Pkwy, Ste 2 MERRITT ISLAND |
| State: | FL |
| Postal Code: | 329534501 |
| Phone Number: | 3216313155 |
| Fax Number: | 3216388684 |
| NPI Enumeration Date: | 08/09/2010 |
| NPI Last Update Date: | 05/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | 12232 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |