MEDICARE: MRS. DIONNE LATRICE HAWKINS MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	22239	MD
2	225100000X	Physical Therapist	PT21584	FL

General Provider Information

NPI Number	:	1205980760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIONNE LATRICE HAWKINS MPT

Provider Business Mailing Address
First Line	:	3609 NW 25TH TERRACE
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32605
Country	:	US
Telephone Number	:	352-359-7813
Fax Number	:

Provider Business Practice Location Address
First Line	:	4820 NEWBERRY ROAD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32607
Country	:	US
Telephone Number	:	352-373-2166
Fax Number	:	352-373-1507

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	01/31/2025

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