Provider Demographics
NPI:1518952753
Name:COOK, DOROTHY (ARNP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:COOK
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 1:2437 E FORT KING ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2558
Mailing Address - Country:US
Mailing Address - Phone:352-351-7000
Mailing Address - Fax:352-236-8610
Practice Address - Street 1:2437 E FORT KING ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2558
Practice Address - Country:US
Practice Address - Phone:352-351-7000
Practice Address - Fax:352-236-8610
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9225306363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306712200Medicaid
FLP30254Medicare UPIN