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NPI Code Detail

MEDICARE: FAITH DORAN

MEDICARE: FAITH DORAN
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
1106S00000XBehavior TechnicianRBT-23-255596FL

General Provider Information

NPI Number : 1669178158
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAITH DORAN
Provider Business Mailing Address
First Line : 8317 FRONT BEACH RD
Second Line :
City : PANAMA CITY BEACH
State : FL
Zip : 32407-4885
Country : US
Telephone Number : 850-714-3287
Fax Number :
Provider Business Practice Location Address
First Line : 8317 FRONT BEACH RD STE 23
Second Line :
City : PANAMA CITY BEACH
State : FL
Zip : 32407-4893
Country : US
Telephone Number : 850-714-3287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2023
Last Update Date : 02/06/2023

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Directions to “ FAITH DORAN ” Practice Location

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