Healthcare Provider Details

I. General information

NPI: 1033503685
Provider Name (Legal Business Name): DAWN GRABOWSKI RDMS, RVT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2015
Last Update Date: 03/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9609 LAUREL LEDGE DR
RIVERVIEW FL
33569-5585
US

IV. Provider business mailing address

9609 LAUREL LEDGE DR
RIVERVIEW FL
33569-5585
US

V. Phone/Fax

Practice location:
  • Phone: 813-236-4088
  • Fax:
Mailing address:
  • Phone: 813-236-4088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number130145
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number130145
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number130145
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: