Healthcare Provider Details

I. General information

NPI: 1528741733
Provider Name (Legal Business Name): DAWN MARIE BIRMELIN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12003 POINCIANA BLVD UNIT 105
ROYAL PALM BEACH FL
33411-2812
US

IV. Provider business mailing address

8023 APPLE VALLEY DR
PASADENA MD
21122-4174
US

V. Phone/Fax

Practice location:
  • Phone: 561-440-3691
  • Fax:
Mailing address:
  • Phone: 561-291-2862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR216654
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR216654
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: