Healthcare Provider Details

I. General information

NPI: 1144403437
Provider Name (Legal Business Name): DONALD CAWOOD LMT,SET
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 12/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5304 DOWNING ST
DOVER FL
33527-5029
US

IV. Provider business mailing address

5304 DOWNING ST
DOVER FL
33527-5029
US

V. Phone/Fax

Practice location:
  • Phone: 813-390-1106
  • Fax: 813-659-1192
Mailing address:
  • Phone: 813-390-1106
  • Fax: 813-659-1192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 42579
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: