Provider Demographics
NPI:1407328693
Name:DORVIL, HANCEAU (NP)
Entity Type:Individual
Prefix:
First Name:HANCEAU
Middle Name:
Last Name:DORVIL
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:HANCEAU
Other - Middle Name:
Other - Last Name:DORVIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HANCEAU DORVIL
Mailing Address - Street 1:7141 SW 158TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3461
Mailing Address - Country:US
Mailing Address - Phone:786-366-2807
Mailing Address - Fax:
Practice Address - Street 1:7141 SW 158TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3461
Practice Address - Country:US
Practice Address - Phone:786-366-2807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-28
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16208-I208D00000X
FL9295958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice