Provider Demographics
NPI:1720214331
Name:CHANG, DAWN SHOREY (ARNP)
Entity type:Individual
Prefix:MISS
First Name:DAWN
Middle Name:SHOREY
Last Name:CHANG
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 ADANSON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1317
Mailing Address - Country:US
Mailing Address - Phone:407-416-5787
Mailing Address - Fax:
Practice Address - Street 1:100 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1006
Practice Address - Country:US
Practice Address - Phone:407-875-3700
Practice Address - Fax:407-822-5024
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2026982363LF0000X
FLAPRN2026982207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine