Basic Information
| Provider Information | |||||||||
| NPI: | 1518341635 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUB | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MSN, CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8760 PEACHTREE PARK CT | ||||||||
| Address2: | |||||||||
| City: | WINDERMERE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347869524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162256103 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6535 NEMOURS PKWY | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328277884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4075674000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2015 | ||||||||
| LastUpdateDate: | 08/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 234368 | NC | N | Nursing Service Providers | Registered Nurse | 163W00000X | RN9470512 | FL | N | Nursing Service Providers | Registered Nurse | 367500000X | 234368 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | APRN9470512 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.