Healthcare Provider Details

I. General information

NPI: 1740699198
Provider Name (Legal Business Name): KARA DODGE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3472 FOREST HILL BLVD STE 3B
PALM SPRINGS FL
33406-5684
US

IV. Provider business mailing address

7593 W BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-8222
  • Fax: 561-963-0509
Mailing address:
  • Phone: 561-649-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9308559
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: