Healthcare Provider Details

I. General information

NPI: 1598536153
Provider Name (Legal Business Name): NESSRENE DOUDAR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9910 SANDALFOOT BLVD STE 1
BOCA RATON FL
33428-6692
US

IV. Provider business mailing address

9910 SANDALFOOT BLVD STE 1
BOCA RATON FL
33428-6692
US

V. Phone/Fax

Practice location:
  • Phone: 561-883-3030
  • Fax: 561-852-7611
Mailing address:
  • Phone: 561-883-3030
  • Fax: 561-852-7611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11030600
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: