Provider Demographics
NPI:1669175519
Name:DOCTEUR, FLORE JOHANNE
Entity type:Individual
Prefix:
First Name:FLORE
Middle Name:JOHANNE
Last Name:DOCTEUR
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 1:5000 NW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5544
Mailing Address - Country:US
Mailing Address - Phone:954-683-2592
Mailing Address - Fax:
Practice Address - Street 1:5000 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5544
Practice Address - Country:US
Practice Address - Phone:954-683-2592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-263219106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician