Provider Demographics
NPI:1043323751
Name:DORFMAN, WILLIAM IRVING (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:IRVING
Last Name:DORFMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:224 COMMERCIAL BLVD
Mailing Address - Street 2:#303
Mailing Address - City:LAUDERDALE BY THE SEA
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4443
Mailing Address - Country:US
Mailing Address - Phone:954-817-4864
Mailing Address - Fax:954-204-3725
Practice Address - Street 1:224 COMMERCIAL BLVD
Practice Address - Street 2:#303
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-4443
Practice Address - Country:US
Practice Address - Phone:954-817-4864
Practice Address - Fax:954-204-3725
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75922Medicare PIN