Healthcare Provider Details

I. General information

NPI: 1225225196
Provider Name (Legal Business Name): DEBORAH LEE DAHL-DAWKINS CRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 S KROME AVE SUITE 104
FLORIDA CITY FL
33034-4906
US

IV. Provider business mailing address

335 S KROME AVE SUITE 104
FLORIDA CITY FL
33034-4906
US

V. Phone/Fax

Practice location:
  • Phone: 305-242-8122
  • Fax: 305-242-8837
Mailing address:
  • Phone: 305-242-8122
  • Fax: 305-242-8837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT13371
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: