Healthcare Provider Details

I. General information

NPI: 1912663097
Provider Name (Legal Business Name): BARBARA DOOLEY REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 NW 71ST CT STE 101
TAMARAC FL
33321-2930
US

IV. Provider business mailing address

7710 NW 71ST CT STE 101
TAMARAC FL
33321-2930
US

V. Phone/Fax

Practice location:
  • Phone: 954-495-4020
  • Fax:
Mailing address:
  • Phone: 954-495-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9202868
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN9202868
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN9202868
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: