Healthcare Provider Details

I. General information

NPI: 1578541371
Provider Name (Legal Business Name): DAWN M GARCEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13120 BISCAYNE BLVD
NORTH MIAMI FL
33181
US

IV. Provider business mailing address

210 WESTCHESTER AVE 3RD FLOOR
WHITE PLAINS NY
10604-2901
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-9210
  • Fax:
Mailing address:
  • Phone: 914-681-3146
  • Fax: 914-682-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number054328
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number109366
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number212444-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: