Healthcare Provider Details

I. General information

NPI: 1720214331
Provider Name (Legal Business Name): DAWN SHOREY CHANG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COLUMBIA ST
ORLANDO FL
32806-1006
US

IV. Provider business mailing address

5151 ADANSON ST
ORLANDO FL
32804-1317
US

V. Phone/Fax

Practice location:
  • Phone: 407-875-3700
  • Fax: 407-822-5024
Mailing address:
  • Phone: 407-416-5787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026982
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN2026982
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberAPRN2026982
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: