Provider Demographics
NPI: | 1932104940 |
---|---|
Name: | DOYLE, NATALIE A (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | NATALIE |
Middle Name: | A |
Last Name: | DOYLE |
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: | 1395 NW 167TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | MIAMI GARDENS |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33169-5710 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 904-559-1844 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9422 ARLINGTON EXPY |
Practice Address - Street 2: | |
Practice Address - City: | JACKSONVILLE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32225-8231 |
Practice Address - Country: | US |
Practice Address - Phone: | 904-559-1844 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-06-16 |
Last Update Date: | 2021-08-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ME152328 | 207R00000X |
NC | 9800846 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 7479 | Other | CIGNA |
NC | 891154R | Medicaid | |
NC | 97560 | Other | MEDCOST |
NC | 1154R | Other | BCBSNC |
NC | 0456366 | Other | UNITEDHEALTHCARE |
NC | 1154R | Other | BCBSNC |
NC | G76505 | Medicare UPIN | |
NC | 97560 | Other | MEDCOST |