Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME0053566 | FL |
NPI | 1043264302 |
---|---|
Provider Name | Dr. Dulce V Dudley |
First Address | Naples, FL 34102-5406 |
Second Address | Naples, FL 34102-5406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 19/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048604300 | (05) | FL |
07336 | BLUE SHIELD (01) | FL |
1201914 | UNITED HEALTH CARE (01) | FL |
40916C | BLUE CROSS (01) | FL |
4236536 | AETNA (01) | FL |
428571 | ONE HEALTH PLAN (01) | FL |
BD1513159 | DEA (01) | FL |
D21205 | (02) | FL |