MEDICARE: DAWN GOODPASTER PA-C

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	363A00000X	Physician Assistant	PA9101211	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	:	1467474601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN GOODPASTER PA-C

Provider Business Mailing Address
First Line	:	1132 SE KINGS BAY DR
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4645
Country	:	US
Telephone Number	:	352-848-4020
Fax Number	:

Provider Business Practice Location Address
First Line	:	3733 E GULF TO LAKE HWY STE A
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34453-3206
Country	:	US
Telephone Number	:	352-341-5520
Fax Number	:	352-341-5523

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	04/29/2025

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Directions to “ DAWN GOODPASTER PA-C” Practice Location

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