MEDICARE: DR. NAMEETA MALA DOOKERAN MD

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	207RA0401X	Addiction Medicine (Internal Medicine) Physician	C183908	CA
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	64943	AZ
3	207RA0401X	Addiction Medicine (Internal Medicine) Physician	ME153695	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	:	1437163615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAMEETA MALA DOOKERAN MD

Provider Business Mailing Address
First Line	:	3181 DAVIE BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2728
Country	:	US
Telephone Number	:	954-603-5021
Fax Number	:

Provider Business Practice Location Address
First Line	:	3181 DAVIE BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2728
Country	:	US
Telephone Number	:	954-603-5021
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	02/04/2025

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