Healthcare Provider Details

I. General information

NPI: 1114621612
Provider Name (Legal Business Name): DURAND CLIFF DORMELUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14590 S MILITARY TRL STE E2-E3
DELRAY BEACH FL
33484-3757
US

IV. Provider business mailing address

8333 NW 53RD ST FL 6
DORAL FL
33166-4783
US

V. Phone/Fax

Practice location:
  • Phone: 561-257-4424
  • Fax: 561-257-4425
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME178136
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: