Provider Demographics
NPI:1851852701
Name:DAWSON, CARA JO (PA-C)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:JO
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:JO
Other - Last Name:LORENZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10001 CHESTER AVE APT 424
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1632
Mailing Address - Country:US
Mailing Address - Phone:814-598-1921
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005741RX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical