Healthcare Provider Details

I. General information

NPI: 1306757935
Provider Name (Legal Business Name): FERNANDO DOREUS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8030 PETERS RD STE D106
PLANTATION FL
33324-4038
US

IV. Provider business mailing address

2970 TOSCANA LN E APT 303
MARGATE FL
33063-8059
US

V. Phone/Fax

Practice location:
  • Phone: 195-447-5950
  • Fax:
Mailing address:
  • Phone: 954-907-8892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: