Provider Demographics
NPI:1982421541
Name:DOLDRON, CHARLIN C (NP)
Entity type:Individual
Prefix:MRS
First Name:CHARLIN
Middle Name:C
Last Name:DOLDRON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:CHARLIN
Other - Middle Name:C
Other - Last Name:DOLDRON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:9200 TIFFANY DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7940
Mailing Address - Country:US
Mailing Address - Phone:786-384-2756
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:786-384-2756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily