Provider Demographics
NPI:1366852766
Name:DOVE MEDICAL CENTERS LLC
Entity Type:Organization
Organization Name:DOVE MEDICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERVIE
Authorized Official - Middle Name:PIERRE
Authorized Official - Last Name:DORVAL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:954-683-0137
Mailing Address - Street 1:2901 W OAKLAND PARK BLVD
Mailing Address - Street 2:A 4-5
Mailing Address - City:OAKLAND PARK,
Mailing Address - State:FL
Mailing Address - Zip Code:33311
Mailing Address - Country:US
Mailing Address - Phone:954-510-3687
Mailing Address - Fax:754-263-5518
Practice Address - Street 1:2901 W OAKLAND PARK BLVD
Practice Address - Street 2:A 4-5
Practice Address - City:OAKLAND PARK,
Practice Address - State:FL
Practice Address - Zip Code:33311
Practice Address - Country:US
Practice Address - Phone:954-510-3687
Practice Address - Fax:754-263-5518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 207RP1001X, 208D00000X
FL9101758363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty