Healthcare Provider Details

I. General information

NPI: 1407455017
Provider Name (Legal Business Name): AMY DANIELLE DOBBERFUHL APRN CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W GRANADA BLVD STE 1
ORMOND BEACH FL
32174-9406
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 386-673-2770
  • Fax: 386-673-2760
Mailing address:
  • Phone: 386-673-2770
  • Fax: 386-673-2760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11011710
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberC160938
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11011710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: