Individual provider Active NPI

Dorit Golan Breiter, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1194923169
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN2564842 Issued in FL
Practice address
4107 W Spruce St Ste 100
Tampa, FL 33607-2346
Phone
(813) 636-8811
Fax
(813) 636-8855
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN2564842 FL Primary

Addresses

Primary practice location

4107 W Spruce St Ste 100
Tampa, FL 33607-2346

Mailing address

4107 W Spruce St Ste 100
Tampa, FL 33607-2346
Phone (813) 636-8811

Other identifiers 1

IdentifierTypeStateIssuer
009309700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN2564842FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1194923169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 W SPRUCE ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072346",
            "telephone_number": "813-636-8811",
            "fax_number": "813-636-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 W SPRUCE ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072346",
            "telephone_number": "813-636-8811",
            "fax_number": "813-636-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITER",
        "first_name": "DORIT",
        "middle_name": "GOLAN",
        "name_prefix": "Dr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN2564842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009309700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.