Healthcare Provider Details

I. General information

NPI: 1346536745
Provider Name (Legal Business Name): ERIN DORVAL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 JOHN F KENNEDY DR
ATLANTIS FL
33462-1120
US

IV. Provider business mailing address

901 S FLAGLER DR PO BOX 24708
WEST PALM BEAC FL
33416-4708
US

V. Phone/Fax

Practice location:
  • Phone: 615-232-2893
  • Fax:
Mailing address:
  • Phone: 561-803-2742
  • Fax: 561-803-2703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS44690
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: