Healthcare Provider Details

I. General information

NPI: 1225190580
Provider Name (Legal Business Name): LUCIENNE DELTOR VALCOURT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E SAMPLE RD STE 107
POMPANO BEACH FL
33064-4443
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 954-210-7016
  • Fax: 954-785-0755
Mailing address:
  • Phone: 954-967-6400
  • Fax: 561-472-9692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME81942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: