Provider Demographics
NPI:1538276019
Name:ZENDEGUI, DAWN MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:ZENDEGUI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:DRAGWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:19417 SHUMARD OAK DRIVE #102
Mailing Address - Street 2:
Mailing Address - City:LAND O'LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638
Mailing Address - Country:US
Mailing Address - Phone:407-366-5057
Mailing Address - Fax:
Practice Address - Street 1:1405 S ORANGE AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2147
Practice Address - Country:US
Practice Address - Phone:407-839-6194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
FLPT21126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT21126OtherLICENSE #