Individual provider Active NPI

Emilienne Marie Dottin

  • Contractor
  • Miami, FL
National Provider Identifier
1902071517
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
300255100 Issued in FL
Practice address
1340 NE 202ND St
Miami, FL 33179-5146
Phone
(305) 652-5191
Fax
(305) 652-5191
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 300255100 FL Primary

Addresses

Primary practice location

1340 NE 202ND St
Miami, FL 33179-5146

Mailing address

1340 NE 202ND St
Miami, FL 33179-5146
Phone (305) 652-5191

Other identifiers 1

IdentifierTypeStateIssuer
300255100MedicaidFL

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

LicenseStateTypeSpecialty
300255100FLMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1902071517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 NE 202ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331795146",
            "telephone_number": "305-652-5191",
            "fax_number": "305-652-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 NE 202ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331795146",
            "telephone_number": "305-652-5191",
            "fax_number": "305-652-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTTIN",
        "first_name": "EMILIENNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "300255100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300255100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.