Provider Demographics
NPI:1922303338
Name:DORMOY, MANUELA (APRN)
Entity Type:Individual
Prefix:MS
First Name:MANUELA
Middle Name:
Last Name:DORMOY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NW 10TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1001
Mailing Address - Country:US
Mailing Address - Phone:305-243-9100
Mailing Address - Fax:305-243-9101
Practice Address - Street 1:1400 NW 10TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1001
Practice Address - Country:US
Practice Address - Phone:305-243-9100
Practice Address - Fax:305-243-9101
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9265385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily