Organization
MARIA D DOHERTY PA
Active
Organization
MARIA D DOHERTY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA DIGNA DOHERTY PEDIATRICIAN, MD (PRESIDENT)
(352) 596-9990
Entity
Organization
Contact information
Practice address
11525 CORTEZ BLVD, BROOKSVILLE, FL 34613-7373
(352) 596-9990
(352) 596-9997
Mailing address
11525 CORTEZ BLVD, BROOKSVILLE, FL 34613-7373
(352) 596-9990
(352) 596-9997
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
ME0062700
FL
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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