Active NPI
Jeff A Dolgan, RCEP
- Clinical Exercise Physiologist
- Davie, FL
National Provider Identifier
1467721084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- License
- 1002242
- Practice address
- 3315 Palomino Drive
Unit 412
Davie, FL 33024-0000 - Phone
- (954) 392-9825
- NPI assigned
- Dec 28, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | 1002242 | FL | Primary |
Addresses
Primary practice location
3315 Palomino Drive
Unit 412
Davie, FL 33024-0000
Mailing address
3315 Palomino Drive
Unit 412
Davie, FL 33024-0000
Phone (954) 392-9825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002242 | FL | MD | Clinical Exercise Physiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325030400000",
"number": "1467721084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3315 PALOMINO DRIVE",
"address_2": "UNIT 412",
"city": "DAVIE",
"state": "FL",
"postal_code": "330240000",
"telephone_number": "954-392-9825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3315 PALOMINO DRIVE",
"address_2": "UNIT 412",
"city": "DAVIE",
"state": "FL",
"postal_code": "330240000",
"telephone_number": "954-392-9825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLGAN",
"first_name": "JEFF",
"middle_name": "A",
"credential": "RCEP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-28",
"last_updated": "2011-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": "FL",
"license": "1002242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.