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Michael Dougherty
Lodging Provider in Boynton Beach, Florida
NPI 1467567073

Michael Dougherty is a Lodging Provider based in Boynton Beach, FL. Michael Dougherty practices in Boynton Beach, FL. The NPI Number for Michael Dougherty is 1467567073 and holds a License No. (Florida).

The current practice location address for Michael Dougherty is 2500 Quantum Lakes Dr, Boynton Beach, FL and can be reached out via phone at 561-244-3627 and via fax at 561-244-9627.

Location: 2500 Quantum Lakes Dr, Boynton Beach, FL, 33426-8324
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467567073
Provider Name
Michael Dougherty
Credential
Provider Entity Type
Individual
Gender
Male
Address
2500 Quantum Lakes Dr, Boynton Beach, FL, 33426-8324
Phone Number
561-244-3627
Fax Number
561-244-9627
Provider Enumeration Date
08/21/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
415 01 FL EMPLOYEE #
institution
Provider Business Practice Location Address Details
Address
2500 Quantum Lakes Dr
City
Boynton Beach
State
Florida
Zip
33426-8324
Phone Number
561-244-3627
Fax Number
561-244-9627
person
Provider Business Mailing Address Details
Address
2500 Quantum Lakes Dr
City
Boynton Beach
State
Florida
Zip
33426-8324
Phone Number
561-244-3627
Fax Number
561-244-9627
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Lodging
Speciality
-
Taxonomy
177F00000X
License No.
()
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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