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NPI Code Detail

MEDICARE: MARILYN DAWSON PT

MEDICARE: MARILYN DAWSON PT
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
1225100000XPhysical TherapistFL

General Provider Information

NPI Number : 1902537160
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN DAWSON PT
Provider Business Mailing Address
First Line : 1173 PERREGRINE CIR E
Second Line :
City : ST JOHNS
State : FL
Zip : 32259-2966
Country : US
Telephone Number : 904-417-5393
Fax Number :
Provider Business Practice Location Address
First Line : 9601 SOUTHBROOK DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-0601
Country : US
Telephone Number : 904-641-7501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2022
Last Update Date : 06/20/2022

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