| Kathryn Doll Llc | |
|
9900 W Sample Rd Ste 309 Coral Springs FL 33065-4048 | |
| (954) 260-8667 | |
| Not Available |
| Full Name | Kathryn Doll Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9900 W Sample Rd Ste 309, Coral Springs, Florida |
| Authorized Official Name and Position | Kathryn Doll (OWNER/MANAGER) |
| Authorized Official Contact | 9542608667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathryn Doll Llc 8500 Nw 79th St Tamarac FL 33321-1659 Ph: (954) 260-8667 | Kathryn Doll Llc 9900 W Sample Rd Ste 309 Coral Springs FL 33065-4048 Ph: (954) 260-8667 |
| NPI Number | 1093256935 |
|---|---|
| Provider Enumeration Date | 03/11/2017 |
| Last Update Date | 10/17/2018 |
| Medicare PECOS PAC ID | 6901170570 |
|---|---|
| Medicare Enrollment ID | O20170920001531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093256935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW 14042 (Florida) | Primary |
| Provider Name | Kathryn Doll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215474499 PECOS PAC ID: 8628342292 Enrollment ID: I20170920001837 |
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