Provider Demographics
NPI:1508434564
Name:DODD, CAROLINE ELIZABETH (PA)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:DODD
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 44047
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4047
Mailing Address - Country:US
Mailing Address - Phone:904-376-4083
Mailing Address - Fax:904-391-5075
Practice Address - Street 1:841 PRUDENTIAL DR STE 280
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8350
Practice Address - Country:US
Practice Address - Phone:904-202-8550
Practice Address - Fax:904-393-7808
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2023-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9114826363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant