Healthcare Provider Details

I. General information

NPI: 1679152979
Provider Name (Legal Business Name): DAWSON INTEGRATIVE & FUNCTIONAL MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10244 E COLONIAL DR STE 204
ORLANDO FL
32817-4338
US

IV. Provider business mailing address

10244 E COLONIAL DR STE 204
ORLANDO FL
32817-4338
US

V. Phone/Fax

Practice location:
  • Phone: 407-777-2673
  • Fax: 407-612-2226
Mailing address:
  • Phone: 407-777-2673
  • Fax: 407-612-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA MARIE DAWSON
Title or Position: OWNER
Credential: LAC
Phone: 407-777-2673