MEDICARE: BARBARA DOOLEY REGISTERED NURSE

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	163WH0200X	Home Health Registered Nurse	RN9202868	FL
2	163WA2000X	Administrator Registered Nurse	RN9202868	FL
3	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	RN9202868	FL

General Provider Information

NPI Number	:	1912663097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA DOOLEY REGISTERED NURSE

Provider Business Mailing Address
First Line	:	7710 NW 71ST CT STE 101
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-2930
Country	:	US
Telephone Number	:	954-495-4020
Fax Number	:

Provider Business Practice Location Address
First Line	:	7710 NW 71ST CT STE 101
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-2930
Country	:	US
Telephone Number	:	954-495-4020
Fax Number	:

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

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	11/12/2021

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