Healthcare Provider Details
I. General information
NPI: 1740098367
Provider Name (Legal Business Name): DOL DOCTORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/28/2024
Last Update Date: 12/28/2024
Certification Date: 12/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6013 WESLEY GROVE BLVD STE 105
WESLEY CHAPEL FL
33544-8415
US
IV. Provider business mailing address
6013 WESLEY GROVE BLVD STE 105
WESLEY CHAPEL FL
33544-8415
US
V. Phone/Fax
- Phone: 813-230-4410
- Fax: 813-886-6959
- Phone: 813-230-4410
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HILDA
OBI-ANADIUME
Title or Position: MEMBER
Credential: DNP
Phone: 813-230-4410