Ibasco, Dorothy Dawn

Ibasco, Dorothy Dawn is an individual health care provider with primary practice located at 450 E Merritt Island Cswy Ste 200 , Merritt Island FL 32952-3503. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Ibasco, Dorothy Dawn can be contacted via phone (321) 735-6220.

Contact Information

Primary practice address
450 E Merritt Island Cswy Ste 200 Merritt Island FL 32952-3503
Phone: (321) 735-6220
Fax: (321) 507-4638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP 9352814 Florida
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X APRN9352814 Florida

Profile Details

NPI number 1356731715
LBN Legal business name Ibasco, Dorothy Dawn
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2015
Last updated May 15th, 2026 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356731715 NPPES
Florida MEDICAID 014492800

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