Provider Demographics
NPI:1063449791
Name:DORTO, ANTHONY JOSEPH (M D)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:DORTO
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3821 N 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1860
Mailing Address - Country:US
Mailing Address - Phone:305-932-4797
Mailing Address - Fax:954-894-3700
Practice Address - Street 1:2627 NE 203RD ST
Practice Address - Street 2:SUITE 116
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1900
Practice Address - Country:US
Practice Address - Phone:305-932-4797
Practice Address - Fax:305-931-4848
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43352208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
D58987Medicare UPIN
FL79940AMedicare ID - Type Unspecified