MEDICARE: DR. NATHAN DVOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	ME141456	FL
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	280440	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184975039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN DVOR M.D.

Provider Business Mailing Address
First Line	:	10300 SW 72ND ST STE 282
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3035
Country	:	US
Telephone Number	:	305-456-6674
Fax Number	:

Provider Business Practice Location Address
First Line	:	10300 SW 72ND ST STE 282
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3035
Country	:	US
Telephone Number	:	305-456-6674
Fax Number	:	305-456-5215

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	05/26/2026

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