Provider Demographics
NPI:1033167457
Name:ROONEY, DORRAINE MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:DORRAINE
Middle Name:MARIE
Last Name:ROONEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12939 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4228
Mailing Address - Country:US
Mailing Address - Phone:813-935-0154
Mailing Address - Fax:
Practice Address - Street 1:12939 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4228
Practice Address - Country:US
Practice Address - Phone:813-935-0154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA44729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist