MEDICARE: DR. GREGORY ANDRE DAWKINS MD

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	207Q00000X	Family Medicine Physician	RTP 002363	GA
2	207R00000X	Internal Medicine Physician	065535	GA
3	208M00000X	Hospitalist Physician	ME114016	FL
4	207R00000X	Internal Medicine Physician	ME114016	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235336819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY ANDRE DAWKINS MD

Provider Business Mailing Address
First Line	:	13067 N TELECOM PKWY
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0926
Country	:	US
Telephone Number	:	813-779-6303
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 SE HILLMOOR DR
Second Line	:	SUITE B-109
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7553
Country	:	US
Telephone Number	:	772-337-9473
Fax Number	:

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

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	03/03/2021

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Directions to “ DR. GREGORY ANDRE DAWKINS MD” Practice Location

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