Provider Demographics
NPI:1942313275
Name:BULGIN, DOROTHY E (ARNP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:E
Last Name:BULGIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-9125
Mailing Address - Country:US
Mailing Address - Phone:772-468-9900
Mailing Address - Fax:772-468-2364
Practice Address - Street 1:725 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-9125
Practice Address - Country:US
Practice Address - Phone:772-468-9900
Practice Address - Fax:772-468-2364
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME2188952363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304788100Medicaid
FLY3980ZMedicare ID - Type Unspecified
560214Medicare UPIN