Provider Demographics
NPI:1972510170
Name:BOWERS, DAWN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:BOWERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-6152
Practice Address - Fax:352-273-6156
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3179103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
74458YMedicare PIN
R04077Medicare UPIN