Provider Demographics
NPI:1952650848
Name:OBANDO-LARGUET, DORIS (RN/NP)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:OBANDO-LARGUET
Suffix:
Gender:F
Credentials:RN/NP
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:
Other - Last Name:OBANDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 HARRISON AVE
Mailing Address - Street 2:DOB 503
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONE BOSTON MEDICAL CENTER PLACE
Practice Address - Street 2:DOWLING ONE SOUTH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-5481
Practice Address - Fax:617-414-7759
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2269921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily