Provider Demographics
NPI:1255356481
Name:GEORGE, DAWN KATHLEEN (MD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:KATHLEEN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2423
Mailing Address - Country:US
Mailing Address - Phone:305-661-1515
Mailing Address - Fax:305-662-3723
Practice Address - Street 1:925 NE 30TH TER STE 100
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7614
Practice Address - Country:US
Practice Address - Phone:786-404-6612
Practice Address - Fax:786-404-6613
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME148647207V00000X
IN01062398A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200847340Medicaid
352106462OtherEIN
202061348OtherEIN
IN200847340Medicaid
I64961Medicare UPIN
163130JMedicare PIN