Healthcare Provider Details

I. General information

NPI: 1457503666
Provider Name (Legal Business Name): DUCLOS DESSALINES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 S CONGRESS AVE STE 101
PALM SPRINGS FL
33461-4746
US

IV. Provider business mailing address

1515 N FLAGLER DR STE 101
WEST PALM BEACH FL
33401-3429
US

V. Phone/Fax

Practice location:
  • Phone: 561-642-1000
  • Fax: 561-804-5629
Mailing address:
  • Phone: 561-659-1270
  • Fax: 561-804-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME102516
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: