Provider Demographics
NPI:1528308863
Name:EINFELDT, DAWN MARIE (OTA6429)
Entity type:Individual
Prefix:MISS
First Name:DAWN
Middle Name:MARIE
Last Name:EINFELDT
Suffix:
Gender:F
Credentials:OTA6429
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 ISLAND DR S
Mailing Address - Street 2:APT/SUITE
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-3714
Mailing Address - Country:US
Mailing Address - Phone:727-560-4624
Mailing Address - Fax:
Practice Address - Street 1:1430 ISLAND DR S
Practice Address - Street 2:APT/SUITE
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-3714
Practice Address - Country:US
Practice Address - Phone:727-560-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-24
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA6429224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant