Provider Demographics
NPI:1154054500
Name:DOUCEUR, CHRISLOR
Entity Type:Individual
Prefix:
First Name:CHRISLOR
Middle Name:
Last Name:DOUCEUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3547 ROCK ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-1166
Mailing Address - Country:US
Mailing Address - Phone:813-295-4137
Mailing Address - Fax:
Practice Address - Street 1:3547 ROCK ROYAL DR
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-1166
Practice Address - Country:US
Practice Address - Phone:813-295-4137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide