Provider Demographics
NPI:1871823849
Name:DOLL, RENEE ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:ELIZABETH
Last Name:DOLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 WELLS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-2982
Mailing Address - Country:US
Mailing Address - Phone:904-282-6331
Mailing Address - Fax:904-619-1080
Practice Address - Street 1:463386 STATE ROAD 200 UNIT A
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-3240
Practice Address - Country:US
Practice Address - Phone:904-468-3080
Practice Address - Fax:904-468-3193
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9335207LP2900X
PAMD448573207L00000X
FLME146609207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02556394Medicaid
LA2156446Medicaid
FL109854100Medicaid