Provider Demographics
NPI:1720391048
Name:DAMBRAUSKAS, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DAMBRAUSKAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 COUNTY ROAD 46A
Mailing Address - Street 2:SUITE 1071 #106
Mailing Address - City:HEATHROW
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4721
Mailing Address - Country:US
Mailing Address - Phone:877-304-6633
Mailing Address - Fax:407-378-4986
Practice Address - Street 1:7025 COUNTY ROAD 46A
Practice Address - Street 2:SUITE 1071 #106
Practice Address - City:HEATHROW
Practice Address - State:FL
Practice Address - Zip Code:32746-4721
Practice Address - Country:US
Practice Address - Phone:877-304-6633
Practice Address - Fax:407-378-4986
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231722372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion