Provider Demographics
NPI:1902180912
Name:LIEBERMAN, DAWN (CRNA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:CAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1381 CITRUS TOWER BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1957
Mailing Address - Country:US
Mailing Address - Phone:352-243-9114
Mailing Address - Fax:352-243-7822
Practice Address - Street 1:1900 DON WICKHAM DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:352-243-9114
Practice Address - Fax:352-243-7822
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9261107367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered