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NPI Code Detail

MEDICARE: DENISE DOLAN

MEDICARE:   DENISE  DOLAN
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
1224Z00000XOccupational Therapy AssistantOTA10442FL

General Provider Information

NPI Number : 1558760033
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE DOLAN
Provider Business Mailing Address
First Line : 3636 NW ADRIATIC LN
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-3111
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3636 NW ADRIATIC LN
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-3111
Country : US
Telephone Number : 772-285-3105
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2014
Last Update Date : 08/20/2014

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Directions to “ DENISE DOLAN ” Practice Location

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