Healthcare Provider Details

I. General information

NPI: 1285845529
Provider Name (Legal Business Name): PATRICIA DAWSON GOLD O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA DAWSON OD

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5687 RED BUG LAKE RD
WINTER SPRINGS FL
32708-4969
US

IV. Provider business mailing address

840 WAKULLA LN
WINTER SPRINGS FL
32708-3831
US

V. Phone/Fax

Practice location:
  • Phone: 321-926-0940
  • Fax:
Mailing address:
  • Phone: 407-539-4856
  • Fax: 407-855-5281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPC4013
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: