Provider Demographics
NPI:1679707038
Name:KOREMAN, DOROTHY G (MD)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:G
Last Name:KOREMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 ISLAND BLVD
Mailing Address - Street 2:APT. 1506
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3785
Mailing Address - Country:US
Mailing Address - Phone:305-682-0424
Mailing Address - Fax:305-682-0424
Practice Address - Street 1:6000 ISLAND BLVD
Practice Address - Street 2:APT. 1506
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-3785
Practice Address - Country:US
Practice Address - Phone:305-682-0424
Practice Address - Fax:305-682-0424
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0016113207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D86469Medicare UPIN
91300Medicare PIN