Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1780716779 Deactivated / Inactive NPI Male Practitioner

Dwight Raymond Bowerman

Speech-Language Pathologist • Lake Placid, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dwight Bowerman has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 12, 2007
NPI Deactivation Date April 09, 2019
Total Practice Duration ~12 Years of Practice (2007 – 2019)

Professional Overview & Biography Verified Profile Summary

Dwight Bowerman was a registered Speech-Language Pathologist practicing in Lake Placid, FL. Throughout an active medical career spanning 12 years, Dwight Bowerman provided care at the practice location at 204 US 27 S until profile deactivation on 2019-04-09.

Practice Location & Contact Primary Location

Practice Address

204 Us 27 S

Lake Placid, FL 338527900

Telephone 8634659500
Associated Practice Facility / Clinic
🏢 Heartland Medical Supply Inc Facility NPI 1457494155

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Lake Placid, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
6 Specialists

Practicing in Lake Placid, FL (11640 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA1103

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Christopher Gentilcore , PTA

Physical Therapy Assistant

NPI 1144815465

Physical Therapist Assistant

Dr. Brittany Roberts , DPT

Physical Therapist

NPI 1265942122

Doctor of Physical Therapy

William Ratterree , PTA

Physical Therapy Assistant

NPI 1417385386

Physical Therapist Assistant

Mark Doskocz , PTA

Physical Therapy Assistant

NPI 1447399894

Physical Therapist Assistant

Andrew Tilford , MSPT

Physical Therapist

NPI 1508977190

Master of Science in Physical Therapy

Yamillet Sanchez , PTA

Physical Medicine & Rehabilitation

NPI 1649835760

Physical Therapist Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 09, 2019

Record deactivated on April 09, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 204 US 27 S, LAKE PLACID, FL 338527900 (Tel: 8634659500)

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Updated Business Mailing Address July 08, 2007

Registered at 149 PENDARVIS RD, LAKE PLACID, FL 338526817 (Tel: 8634653612)

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Provider Name / Credentials Updated July 08, 2007

Recorded as DWIGHT BOWERMAN

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Speech-Language Pathologist (License #SA1103 in FL)

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Initial NPI Registration & Enumeration March 12, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780716779
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 12, 2007
Last Update: July 08, 2007
Deactivation Date: April 09, 2019

Mailing Address

149 Pendarvis Rd

Lake Placid, FL 338526817

Phone: 8634653612

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.