Basic Information
| Provider Information | |||||||||
| NPI: | 1831566181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOREUS | ||||||||
| FirstName: | NATASHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSN, AGACNP-BC, CEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7400 SW 87TH AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331735458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052758200 | ||||||||
| FaxNumber: | 3052747812 | ||||||||
| Practice Location | |||||||||
| Address1: | 7400 SW 87TH AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052758200 | ||||||||
| FaxNumber: | 3052747812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2015 | ||||||||
| LastUpdateDate: | 07/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 9330052 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | 247616 | GA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.