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NPI Code Detail

MEDICARE: DORIT WILSON APRN

MEDICARE:   DORIT  WILSON  APRN
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
1363LF0000XFamily Nurse Practitioner11003462FL

General Provider Information

NPI Number : 1710537915
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORIT WILSON APRN
Provider Business Mailing Address
First Line : 9732 NW 46TH MNR
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33076-2604
Country : US
Telephone Number : 954-295-6782
Fax Number : 954-295-6782
Provider Business Practice Location Address
First Line : 9732 NW 46TH MNR
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33076-2604
Country : US
Telephone Number : 954-234-8975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2019
Last Update Date : 09/19/2019

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Directions to “ DORIT WILSON APRN” Practice Location

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