| Dawn Smith Walsh, Aprn-bc, Pllc | |
|
14910 N Dale Mabry Hwy # 342203 Tampa FL 33618-1814 | |
| (813) 838-1740 | |
| Not Available |
| Full Name | Dawn Smith Walsh, Aprn-bc, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 14910 N Dale Mabry Hwy # 342203, Tampa, Florida |
| Authorized Official Name and Position | Dawn Smith Walsh (MANAGER/OWNER) |
| Authorized Official Contact | 8138381740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dawn Smith Walsh, Aprn-bc, Pllc 14910 N Dale Mabry Hwy # 342203 Tampa FL 33618-1814 Ph: (813) 838-1740 | Dawn Smith Walsh, Aprn-bc, Pllc 14910 N Dale Mabry Hwy # 342203 Tampa FL 33618-1814 Ph: (813) 838-1740 |
| NPI Number | 1063086577 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 02/20/2023 |
| Certification Date | 02/15/2023 |
| Medicare PECOS PAC ID | 0446659379 |
|---|---|
| Medicare Enrollment ID | O20210526002493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063086577 | NPI | - | NPPES |
| 1992030696 | Other | FL | NPI |
| 113873900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Dawn Smith Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992030696 PECOS PAC ID: 8123459468 Enrollment ID: I20201015000853 |
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