Provider Demographics
NPI:1730699307
Name:DORISCA, MOGINE CHERENFANT (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MOGINE
Middle Name:CHERENFANT
Last Name:DORISCA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 NW 3RD CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2720
Mailing Address - Country:US
Mailing Address - Phone:954-296-9451
Mailing Address - Fax:
Practice Address - Street 1:4712 NW 3RD CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2720
Practice Address - Country:US
Practice Address - Phone:954-296-9451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9240140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily