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NPI Code Detail

MEDICARE: DR. GEETANJALI DODSON D.O.

MEDICARE: DR. GEETANJALI DODSON D.O.
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
1207Q00000XFamily Medicine PhysicianA-2431-20NM
2207Q00000XFamily Medicine PhysicianOS10744FL

General Provider Information

NPI Number : 1366673881
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEETANJALI DODSON D.O.
Provider Business Mailing Address
First Line : 1643 NW 136 AVE BLDG. H STE. 100
Second Line : MSC 11607-0004
City : SUNRISE
State : FL
Zip : 33323-2857
Country : US
Telephone Number : 954-377-3071
Fax Number : 856-560-7110
Provider Business Practice Location Address
First Line : 1005 LUJAN HILL RD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-6304
Country : US
Telephone Number : 575-523-4573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2009
Last Update Date : 03/11/2021

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