Provider Demographics
NPI:1992380497
Name:DAWSON, DINA JOYCE
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:JOYCE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-6266
Mailing Address - Country:US
Mailing Address - Phone:954-607-8602
Mailing Address - Fax:
Practice Address - Street 1:59 COLONY LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2218
Practice Address - Country:US
Practice Address - Phone:954-607-8602
Practice Address - Fax:954-545-2381
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator