Individual
DR. NICHOLAS R DODARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 396-5682
(904) 346-0864
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-3312
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME77751
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000843301I
—
GA
05
—
000843301J
—
GA
05
—
271806500
—
FL
01
—
62036
BCBS
FL
Enumeration date
07/19/2006
Last updated
05/03/2017
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