Provider Demographics
NPI:1619932365
Name:DORFMAN, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DORFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8395 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7301
Mailing Address - Country:US
Mailing Address - Phone:954-741-7500
Mailing Address - Fax:954-741-7003
Practice Address - Street 1:8395 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7301
Practice Address - Country:US
Practice Address - Phone:954-741-7500
Practice Address - Fax:954-741-7003
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0033795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00751263OtherRAILROAD MEDICARE
FL068908400Medicaid
FLP00751263OtherRAILROAD MEDICARE
FL068908400Medicaid
FL93714ZMedicare PIN