MEDICARE: CHRISTINA MARIE DODDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11000017	FL
2	207Q00000X	Family Medicine Physician	ARNP11000017	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205399664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA MARIE DODDS

Provider Business Mailing Address
First Line	:	1100 SW 19TH ST
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33486-6712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 COSTA DEL SOL
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-1746
Country	:	US
Telephone Number	:	561-802-7874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2019
Last Update Date	:	04/27/2026

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Directions to “ CHRISTINA MARIE DODDS ” Practice Location

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