Provider Demographics
NPI:1922615608
Name:DORFMAN, URSZULA (APRN)
Entity Type:Individual
Prefix:
First Name:URSZULA
Middle Name:
Last Name:DORFMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:URSZULA
Other - Middle Name:
Other - Last Name:DORFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1 LAS OLAS CIR APT 609
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1634
Mailing Address - Country:US
Mailing Address - Phone:954-296-6356
Mailing Address - Fax:
Practice Address - Street 1:1 LAS OLAS CIR APT 609
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1634
Practice Address - Country:US
Practice Address - Phone:954-296-6356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11007474363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health