Provider Demographics
NPI:1619903812
Name:DAVID B RAWLINGS PHD PA
Entity Type:Organization
Organization Name:DAVID B RAWLINGS PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAWLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PA
Authorized Official - Phone:239-430-2303
Mailing Address - Street 1:PO BOX 11228
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-1228
Mailing Address - Country:US
Mailing Address - Phone:239-430-2303
Mailing Address - Fax:239-430-2304
Practice Address - Street 1:720 GOODLETTE RD N
Practice Address - Street 2:201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5656
Practice Address - Country:US
Practice Address - Phone:239-430-2303
Practice Address - Fax:239-430-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0004889103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59432OtherB/C
FL59432YMedicare PIN