Provider Demographics
NPI:1710551163
Name:FRAZIER, DORSELY LASHAY
Entity Type:Individual
Prefix:
First Name:DORSELY
Middle Name:LASHAY
Last Name:FRAZIER
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 1:14 HIBISCUS LN
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-4545
Mailing Address - Country:US
Mailing Address - Phone:727-643-4344
Mailing Address - Fax:
Practice Address - Street 1:99198 OVERSEAS HWY STE 3
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-2437
Practice Address - Country:US
Practice Address - Phone:305-434-7660
Practice Address - Fax:305-451-8019
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator