Provider Demographics
NPI:1114560406
Name:DONDI, CAROLINE (APRN)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:DONDI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 N UNIVERSITY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2968
Mailing Address - Country:US
Mailing Address - Phone:954-720-1930
Mailing Address - Fax:
Practice Address - Street 1:21301 POWERLINE RD STE 108
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2388
Practice Address - Country:US
Practice Address - Phone:561-877-8675
Practice Address - Fax:561-672-1365
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-20
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty