Individual
DOROTHEA N DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13535 NEMOURS PKWY, ORLANDO, FL 32827-7402
(407) 567-4000
(407) 567-5924
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(904) 697-5062
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
38143
AZ
2080P0207X
Pediatric Hematology & Oncology Physician
38143
AZ
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
ME123751
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345267
—
AZ
Enumeration date
01/14/2008
Last updated
07/26/2015
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