MRS. DAWN RAE MACK (NPI# 1659674893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659674893 |
| Entity Type | Individual |
| Full Name | MRS. DAWN RAE MACK |
| Other Name | MRS. DAWN RAE PAUL |
| Practice Address |
2104 55th Ave W Bradenton FL 34207-3240 |
| Practice Telephone | 9417277304 |
| Practice Fax Number | 9417560741 |
| Mailing Telephone | 9417277304 |
| Mailing Fax Number | 9417560741 |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2010-12-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906357 | FL | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366898686 | Dawn Mack | Occupational Therapy Assistant | 1776 S 17th St, Wilmington, NC 28401-6442 | 2016-05-05 |
| Street Address |
2104 55TH AVE W |
| City | BRADENTON |
| State | FL |
| Zip Code | 34207-3240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114472263 | Rudy's Agape House, LLC | Assisted Living Facility | 2104 55th Ave W, Bradenton, FL 34207-3240 | 2016-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932760543 | Yaima Alba | Dentist | 1602 State Hwy 684 W, Bradenton, FL 34207 | 2019-06-25 |
| 1770069361 | America's Pharmacy LLC. | Pharmacy | 5612 14th St W, Bradenton, FL 34207 | 2018-07-17 |
| 1265817829 | Elizabeth Anne Gross Baumgartner | Nurse Practitioner | 5515 27th St West, Bradenton, FL 34207 | 2015-07-24 |
| 1710152673 | Oasis Temps Health Care, Inc. | Nursing Care | 4814 26th Street West, Unit B, Bradenton, FL 34207 | 2008-04-22 |
| 1669694873 | Comfortable Care Dental Health Professionals, Pa | Dentist | 6513 14th Street West, Suite 131, Bradenton, FL 34207 | 2007-05-03 |
| 1831258524 | Susan Marie Mackey | Counselor | New View Counseling, 4506 26th Street West Suite C, Bradenton, FL 34207 | 2006-12-08 |
| 1073672333 | Debra K Carter | Psychologist | 4835 27th St West, Suite 125, Bradenton, FL 34207 | 2006-12-06 |
| 1033285952 | Neuromuscular Insitutute Inc | Physical Therapist | 4802 26th St West, Suite C, Bradenton, FL 34207 | 2006-11-24 |
| 1346315561 | Judith Rhea Korn | Social Worker | 6108 26th St West, Suite 3b, Bradenton, FL 34207 | 2006-11-22 |
| 1770652018 | Richard Allen Feasley | Dentist | 4418 5th St W, Bradenton, FL 34207 | 2006-11-08 |
| Find all providers in zip 34207 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760032460 | Ronald Abner Dieudonne | Custodial Care Facility | 804 36th Ave E, Bradenton, FL 34208-4528 | 2019-09-14 |
| 1194379081 | Darleen Allen | Custodial Care Facility | 208 42nd Ave E # A, Bradenton, FL 34208-4412 | 2019-07-29 |
| 1336685106 | Carla Henderson | Custodial Care Facility | 5103 19th Ct E, Bradenton, FL 34203-4266 | 2017-01-17 |
| 1609117621 | Lorraine Assisted Care Dba Melissa Ann Bongart | Custodial Care Facility | 5916 Lorraine Rd, Bradenton, FL 34211-9208 | 2013-03-15 |
| 1780014027 | Evadney E Walker-avoine | Custodial Care Facility | 201 22nd Street Ct Ne, Bradenton, FL 34208-1756 | 2013-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497243 | Two Kinds of Hearts 'llc' | Custodial Care Facility | 1808 Oak Pond Street, Ruskin, FL 33570 | 2020-11-03 |
| 1881293843 | Inspire Family Home Care LLC. | Custodial Care Facility | 566 Forsyth Creek Ct, Apopka, FL 32712-3318 | 2020-10-21 |
| 1336747658 | Eddrena Thornton | Custodial Care Facility | 2233 Bluebird Ave, Bartow, FL 33830-2953 | 2020-10-09 |
| 1689280083 | Wendy Del Rosario Toledo Machado | Custodial Care Facility | 7101 Green St, New Port Richey, FL 34652-1630 | 2020-09-21 |
| 1568077469 | Titilayo M Dipe | Custodial Care Facility | 11215 Gold Compass St, Gibsonton, FL 33534-5698 | 2020-09-09 |
| 1124630892 | Moselene Belizaire | Custodial Care Facility | 3411 9th St W, Lehigh Acres, FL 33971-5357 | 2020-08-23 |
| 1396354395 | Unique Adult Family Care Home Inc. | Custodial Care Facility | 7149 Glenwood Dr, Boynton Beach, FL 33436-9404 | 2020-07-24 |
| 1790301687 | Nancy Isidor | Custodial Care Facility | 1728 Burnham Ct, Clermont, FL 34714-8048 | 2020-06-17 |
| 1326662206 | Yuwaret Haines | Custodial Care Facility | 13566 Rudi Loop, Spring Hill, FL 34609-7964 | 2020-06-05 |
| 1245854686 | Yves Carmen Dorsainvil | Custodial Care Facility | 631 Sw Sardinia Ave, Port Saint Lucie, FL 34953-3746 | 2020-06-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.