Provider Demographics
NPI:1538991021
Name:DOTEN, MADISON MARIE (BS)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MARIE
Last Name:DOTEN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6807 COLLEGE CT APT 11-204
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33317-7168
Mailing Address - Country:US
Mailing Address - Phone:518-225-8013
Mailing Address - Fax:
Practice Address - Street 1:7700 RENFREW LN
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3508
Practice Address - Country:US
Practice Address - Phone:800-736-3739
Practice Address - Fax:954-698-6007
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program