Healthcare Provider Details

I. General information

NPI: 1558661322
Provider Name (Legal Business Name): COLEEN L DOOLEY ARNP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 N ROOSEVELT BLVD SUITE 6
KEY WEST FL
33040-3837
US

IV. Provider business mailing address

PO BOX 420346
SUMMERLAND KEY FL
33042-0346
US

V. Phone/Fax

Practice location:
  • Phone: 305-745-8215
  • Fax:
Mailing address:
  • Phone: 305-745-8215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberARNP 624842
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberARNP 624842
License Number StateFL

VIII. Authorized Official

Name: COLEEN L DOOLEY
Title or Position: DIRECTOR/SOLE PROVIDER
Credential: ARNP
Phone: 305-745-3768