Provider Demographics
NPI:1164824355
Name:ALBISA, DORAIKY (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:DORAIKY
Middle Name:
Last Name:ALBISA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 NW 42ND AVE
Mailing Address - Street 2:APT 909
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5416
Mailing Address - Country:US
Mailing Address - Phone:786-693-3247
Mailing Address - Fax:
Practice Address - Street 1:955 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1274
Practice Address - Country:US
Practice Address - Phone:305-416-5722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9213740363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health