Healthcare Provider Details

I. General information

NPI: 1568989721
Provider Name (Legal Business Name): FILIZ DOLAT HC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 W MISSOURI AVE
PHOENIX AZ
85013-1909
US

IV. Provider business mailing address

919 W MISSOURI AVE
PHOENIX AZ
85013-1909
US

V. Phone/Fax

Practice location:
  • Phone: 305-331-1991
  • Fax:
Mailing address:
  • Phone: 305-331-1991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: