Provider Demographics
NPI:1356446223
Name:DOOLIN, DINA (DO)
Entity type:Individual
Prefix:DR
First Name:DINA
Middle Name:
Last Name:DOOLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:233 N CAUSEWAY
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-5239
Mailing Address - Country:US
Mailing Address - Phone:386-957-9850
Mailing Address - Fax:386-410-3731
Practice Address - Street 1:233 N CAUSEWAY
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169-5239
Practice Address - Country:US
Practice Address - Phone:386-957-9850
Practice Address - Fax:386-410-3731
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8699207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
51400ZMedicare PIN
H47444Medicare UPIN