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General NPI Number Information
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NPI Number | 1871875591
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Entity Type | Individual
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Provider Name | AIMEE DOUGHERTY ARNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 4202 E FOWLER AVE SHS100
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City | TAMPA
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State | FL
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Zip | 33620-6750
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Country | US
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Telephone | 813-974-2331
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 917770
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City | ORLANDO
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State | FL
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Zip | 32891-0001
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Country | US
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Telephone | 813-974-2201
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Fax | 813-974-2812
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN3392062
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License Number State | FL
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