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NPI Code Detail

MEDICARE: JESSICA L DODDY

MEDICARE: JESSICA L DODDY
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376670083
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA L DODDY
Provider Business Mailing Address
First Line : 6600 NE 22ND WAY
Second Line : #2312
City : FT LAUDERDALE
State : FL
Zip : 33308-1273
Country : US
Telephone Number : 954-731-1000
Fax Number : 954-497-3857
Provider Business Practice Location Address
First Line : 2900 W PROSPECT RD
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-2519
Country : US
Telephone Number : 954-731-1000
Fax Number : 954-497-3857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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Directions to “ JESSICA L DODDY ” Practice Location

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