Provider Demographics
NPI:1013715788
Name:IYPE, DOLLY (NP)
Entity type:Individual
Prefix:MRS
First Name:DOLLY
Middle Name:
Last Name:IYPE
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 GREENBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3832
Mailing Address - Country:US
Mailing Address - Phone:954-881-2574
Mailing Address - Fax:
Practice Address - Street 1:4230 GREENBRIAR LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3832
Practice Address - Country:US
Practice Address - Phone:954-881-2574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037457363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care