Healthcare Provider Details

I. General information

NPI: 1033537725
Provider Name (Legal Business Name): LOWELL DEAN DAWSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 7TH ST S STE 400
ST PETERSBURG FL
33701-4734
US

IV. Provider business mailing address

603 7TH ST S STE 400
ST PETERSBURG FL
33701-4734
US

V. Phone/Fax

Practice location:
  • Phone: 727-893-6435
  • Fax: 727-893-6436
Mailing address:
  • Phone: 727-893-6435
  • Fax: 727-893-6436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME129383
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME129383
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberME129383
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: