Healthcare Provider Details
I. General information
NPI: 1891754230
Provider Name (Legal Business Name): JAMES M. DOTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2006
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 NW 84TH AVE STE 311
PLANTATION FL
33324-1817
US
IV. Provider business mailing address
350 NW 84TH AVE STE 311
PLANTATION FL
33324-1817
US
V. Phone/Fax
- Phone: 954-476-9899
- Fax: 954-476-9180
- Phone: 954-476-9899
- Fax: 954-476-9180
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | ME88638 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: