Provider Demographics
NPI:1710966361
Name:JARAMILLO-DOLAN, MARIA T (DPM)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:T
Last Name:JARAMILLO-DOLAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 6TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4630
Mailing Address - Country:US
Mailing Address - Phone:863-299-4551
Mailing Address - Fax:
Practice Address - Street 1:101 6TH ST NW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4630
Practice Address - Country:US
Practice Address - Phone:863-299-4551
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2804213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO2804OtherFLORIDA LICENSE NUMBER
FLU87138Medicare UPIN
FLPO2804OtherFLORIDA LICENSE NUMBER