MEDICARE: DANIEL DOUCETTE APRN

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	363LF0000X	Family Nurse Practitioner	ARNP3361142	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	:	1467840868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL DOUCETTE APRN

Provider Business Mailing Address
First Line	:	4 CEDARFIELD CT
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-8950
Country	:	US
Telephone Number	:	386-916-9488
Fax Number	:

Provider Business Practice Location Address
First Line	:	647 ORANGE AVE
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-6731
Country	:	US
Telephone Number	:	386-252-5501
Fax Number	:

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

Provider Enumeration Date	:	01/07/2015
Last Update Date	:	02/05/2020

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