Provider Demographics
NPI:1902098106
Name:CLEVELAND, LOWELL ANTHONY (RCS)
Entity Type:Individual
Prefix:MR
First Name:LOWELL
Middle Name:ANTHONY
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:614 GIBBS ROAD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809
Mailing Address - Country:US
Mailing Address - Phone:706-414-8900
Mailing Address - Fax:651-417-7443
Practice Address - Street 1:5901 BROKEN SOUND PKWY NW
Practice Address - Street 2:SUITE 500
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2773
Practice Address - Country:US
Practice Address - Phone:561-367-1175
Practice Address - Fax:561-417-7443
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA00015576246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography