Basic Information
| Provider Information | |||||||||
| NPI: | 1619280468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOERINGER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34621 US 19 N | ||||||||
| Address2: | |||||||||
| City: | PALM HARBOR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346842152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7279539888 | ||||||||
| FaxNumber: | 7279450133 | ||||||||
| Practice Location | |||||||||
| Address1: | 34621 US 19 N | ||||||||
| Address2: | |||||||||
| City: | PALM HARBOR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346842152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7279539888 | ||||||||
| FaxNumber: | 7279450133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2010 | ||||||||
| LastUpdateDate: | 04/09/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS11577 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | OS11577 | 01 | FL | MEDICAL LICENSE | OTHER |