Healthcare Provider Details

I. General information

NPI: 1942313275
Provider Name (Legal Business Name): DOROTHY E BULGIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N US HIGHWAY 1
FORT PIERCE FL
34950-9125
US

IV. Provider business mailing address

725 N US HIGHWAY 1
FORT PIERCE FL
34950-9125
US

V. Phone/Fax

Practice location:
  • Phone: 772-468-9900
  • Fax: 772-468-2364
Mailing address:
  • Phone: 772-468-9900
  • Fax: 772-468-2364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberME2188952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: