Provider Demographics
NPI:1689280349
Name:DOUYARD, FABIOLA (APRN)
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:
Last Name:DOUYARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15805 SW 52ND CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5616
Mailing Address - Country:US
Mailing Address - Phone:954-635-7667
Mailing Address - Fax:
Practice Address - Street 1:15805 SW 52ND CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5616
Practice Address - Country:US
Practice Address - Phone:954-635-7667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF09200592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily