Healthcare Provider Details

I. General information

NPI: 1902755002
Provider Name (Legal Business Name): DARE TO IMAGINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 PONCE DE LEON BLVD
BROOKSVILLE FL
34601-1236
US

IV. Provider business mailing address

716 PONCE DE LEON BLVD
BROOKSVILLE FL
34601-1236
US

V. Phone/Fax

Practice location:
  • Phone: 352-650-8219
  • Fax:
Mailing address:
  • Phone: 352-650-8219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIMOTHY DIXON
Title or Position: OWNER
Credential: DIXON
Phone: 352-650-8219