Healthcare Provider Details
I. General information
NPI: 1255656419
Provider Name (Legal Business Name): SAPNA DHAWAN MD, OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/31/2010
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4918 N HABANA AVE
TAMPA FL
33614-6815
US
IV. Provider business mailing address
2995 DREW ST
CLEARWATER FL
33759-3012
US
V. Phone/Fax
- Phone: 866-762-1743
- Fax: 727-816-1222
- Phone: 727-281-9065
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 35.146506 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 3914 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | ME159262 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: