Provider Demographics
NPI:1285636233
Name:RAWLINGS, DAVID B (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11228
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-1228
Mailing Address - Country:US
Mailing Address - Phone:239-430-2303
Mailing Address - Fax:239-430-2304
Practice Address - Street 1:720 GOODLETTE RD N
Practice Address - Street 2:STE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5656
Practice Address - Country:US
Practice Address - Phone:239-430-2303
Practice Address - Fax:230-430-2304
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-10-22
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FLPY0004889103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59432YMedicare PIN
FLR55281Medicare UPIN