Provider Demographics
NPI:1285027425
Name:BARTOLUCCI, DORIS
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:
Last Name:BARTOLUCCI
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 1:581 MOSSY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-4494
Mailing Address - Country:US
Mailing Address - Phone:413-636-4700
Mailing Address - Fax:
Practice Address - Street 1:581 MOSSY CREEK DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-4494
Practice Address - Country:US
Practice Address - Phone:413-636-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5026237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist