MEDICARE: L DAWSON GLADDING PA

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	OS3902	FL

General Provider Information

NPI Number	:	1275716599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L DAWSON GLADDING PA

Provider Business Mailing Address
First Line	:	1491 BEECHWOOD TRL
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3430
Country	:	US
Telephone Number	:	239-482-6254
Fax Number	:	239-432-0548

Provider Business Practice Location Address
First Line	:	1491 BEECHWOOD TRL
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3430
Country	:	US
Telephone Number	:	239-482-6254
Fax Number	:	239-432-0548

Authorized Official
Title or Position	:	PRES
Name	:	DR. LLOYD DAWSON GLADDING
Credential	:	D.O.
Telephone Number	:	239-425-6464

Provider Enumeration Date	:	12/10/2007
Last Update Date	:	12/10/2007

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