Healthcare Provider Details

I. General information

NPI: 1750032348
Provider Name (Legal Business Name): KAISHIA DAINE DOLLAR REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5521 SW 99TH AVE
COOPER CITY FL
33328-5705
US

IV. Provider business mailing address

5521 SW 99TH AVE
COOPER CITY FL
33328-5705
US

V. Phone/Fax

Practice location:
  • Phone: 786-624-9693
  • Fax:
Mailing address:
  • Phone: 786-624-9693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11047705
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: