Provider Demographics
NPI:1861805145
Name:SCHULZ, DAWN (MA)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 NW 20TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-1860
Mailing Address - Country:US
Mailing Address - Phone:801-318-0786
Mailing Address - Fax:
Practice Address - Street 1:4820 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2249
Practice Address - Country:US
Practice Address - Phone:352-373-2116
Practice Address - Fax:352-373-1507
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 56055225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist