Provider Demographics
NPI:1245854686
Name:DORSAINVIL, YVES CARMEN
Entity type:Individual
Prefix:
First Name:YVES CARMEN
Middle Name:
Last Name:DORSAINVIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 SW SARDINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3746
Mailing Address - Country:US
Mailing Address - Phone:561-541-0059
Mailing Address - Fax:
Practice Address - Street 1:631 SW SARDINIA AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3746
Practice Address - Country:US
Practice Address - Phone:561-541-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home