Provider Demographics
NPI:1609536200
Name:DORAZIO, ASHLEY (RDMS, MA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DORAZIO
Suffix:
Gender:F
Credentials:RDMS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BALTIMORE LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8850
Mailing Address - Country:US
Mailing Address - Phone:386-589-0172
Mailing Address - Fax:
Practice Address - Street 1:1667 N CLYDE MORRIS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5500
Practice Address - Country:US
Practice Address - Phone:386-274-1414
Practice Address - Fax:386-256-3008
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
2453502471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography