Provider Demographics
NPI:1225225196
Name:DAHL-DAWKINS, DEBORAH LEE (CRT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEE
Last Name:DAHL-DAWKINS
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 S KROME AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-4906
Mailing Address - Country:US
Mailing Address - Phone:305-242-8122
Mailing Address - Fax:305-242-8837
Practice Address - Street 1:335 S KROME AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-4906
Practice Address - Country:US
Practice Address - Phone:305-242-8122
Practice Address - Fax:305-242-8837
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT13371227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892179200Medicaid