Healthcare Provider Details
I. General information
NPI: 1699227652
Provider Name (Legal Business Name): DAWN WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1120 NW 23RD AVE
GAINESVILLE FL
32609-3441
US
IV. Provider business mailing address
1120 NW 23RD AVE
GAINESVILLE FL
32609-3441
US
V. Phone/Fax
- Phone: 352-792-6700
- Fax: 352-792-6661
- Phone: 352-792-6700
- Fax: 352-792-6661
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | OS8986 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
APRIL DAWN
HURT
Title or Position: MANAGER
Credential: D.O.
Phone: 352-262-8970