MEDICARE: AMY DANIELLE DOBBERFUHL APRN CPNP-PC

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	363LP0200X	Pediatric Nurse Practitioner	APRN11011710	FL
2	363LP0200X	Pediatric Nurse Practitioner	C160938	IA
3	363L00000X	Nurse Practitioner	APRN11011710	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	:	1407455017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY DANIELLE DOBBERFUHL APRN CPNP-PC

Provider Business Mailing Address
First Line	:	900 S PINE ISLAND RD STE 800
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3923
Country	:	US
Telephone Number	:	386-673-2770
Fax Number	:	386-673-2760

Provider Business Practice Location Address
First Line	:	725 W GRANADA BLVD STE 1
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-9406
Country	:	US
Telephone Number	:	386-673-2770
Fax Number	:	386-673-2760

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

Provider Enumeration Date	:	10/23/2020
Last Update Date	:	01/22/2026

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