MEDICARE: KAREN MICHELE DOTSON FNP-BC

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	363LF0000X	Family Nurse Practitioner	APRN9231206	FL
2	208D00000X	General Practice Physician	RN9231206	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760981450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN MICHELE DOTSON FNP-BC

Provider Business Mailing Address
First Line	:	6135 LAKE LIZZIE DR
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8523
Country	:	US
Telephone Number	:	407-301-2282
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 LIVE OAK BLVD STE B
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8410
Country	:	US
Telephone Number	:	407-593-2911
Fax Number	:	888-728-0246

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

Provider Enumeration Date	:	02/07/2018
Last Update Date	:	04/23/2021

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