MEDICARE: DORATHY N NDIOLO

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	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	163WP0807X	FL

General Provider Information

NPI Number	:	1386589406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORATHY N NDIOLO

Provider Business Mailing Address
First Line	:	11051 SW 197TH ST APT 309
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-8485
Country	:	US
Telephone Number	:	734-410-5352
Fax Number	:

Provider Business Practice Location Address
First Line	:	11051 SW 197TH ST APT 309
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-8485
Country	:	US
Telephone Number	:	734-410-5352
Fax Number	:

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

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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Directions to “ DORATHY N NDIOLO ” Practice Location

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