MEDICARE: DOTHY NAISSANCE

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	164W00000X	Licensed Practical Nurse	5269798	FL

General Provider Information

NPI Number	:	1588518278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOTHY NAISSANCE

Provider Business Mailing Address
First Line	:	3841 ENVIRON BLVD APT 531
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-4294
Country	:	US
Telephone Number	:	954-607-8480
Fax Number	:

Provider Business Practice Location Address
First Line	:	3841 ENVIRON BLVD APT 531
Second Line	:	APT 531
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-4294
Country	:	US
Telephone Number	:	954-607-8480
Fax Number	:

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

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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