MEDICARE: MS. DOLORES ANN DOWDALL R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9163632	FL

General Provider Information

NPI Number	:	1629196092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DOLORES ANN DOWDALL R.N.

Provider Business Mailing Address
First Line	:	820 VIRGINIA ST
Second Line	:	#204 BLDG 10
City	:	DUNEDIN
State	:	FL
Zip	:	34698-6767
Country	:	US
Telephone Number	:	727-736-3177
Fax Number	:

Provider Business Practice Location Address
First Line	:	7402 N 56TH ST
Second Line	:	SUITE 906
City	:	TAMPA
State	:	FL
Zip	:	33617-7733
Country	:	US
Telephone Number	:	727-536-4119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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