Healthcare Provider Details

I. General information

NPI: 1619960473
Provider Name (Legal Business Name): DAWN O ECKHOFF ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 11/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 W COCOA BEACH CSWY
COCOA BEACH FL
32931-3577
US

IV. Provider business mailing address

134 S WOODS DR
ROCKLEDGE FL
32955-3262
US

V. Phone/Fax

Practice location:
  • Phone: 321-784-5437
  • Fax: 321-799-1231
Mailing address:
  • Phone: 321-636-3066
  • Fax: 321-636-2545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP 2160232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: