Healthcare Provider Details

I. General information

NPI: 1619903812
Provider Name (Legal Business Name): DAVID B RAWLINGS PHD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 GOODLETTE RD N 201
NAPLES FL
34102-5656
US

IV. Provider business mailing address

PO BOX 11228
NAPLES FL
34101-1228
US

V. Phone/Fax

Practice location:
  • Phone: 239-430-2303
  • Fax: 239-430-2304
Mailing address:
  • Phone: 239-430-2303
  • Fax: 239-430-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY0004889
License Number StateFL

VIII. Authorized Official

Name: DAVID B RAWLINGS
Title or Position: OWNER
Credential: PHD PA
Phone: 239-430-2303