Healthcare Provider Details

I. General information

NPI: 1457740409
Provider Name (Legal Business Name): DORSALIS ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2015
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7421 N UNIVERSITY DR SUITE 304
TAMARAC FL
33321-2977
US

IV. Provider business mailing address

7421 N UNIVERSITY DR SUITE 304
TAMARAC FL
33321-2977
US

V. Phone/Fax

Practice location:
  • Phone: 954-722-8080
  • Fax: 954-722-4093
Mailing address:
  • Phone: 954-722-8080
  • Fax: 954-722-4093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO629
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3441
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3195
License Number StateFL

VIII. Authorized Official

Name: DR. NEIL HOWARD STRAUSS
Title or Position: PRESIDENT/PARTNER
Credential: DPM
Phone: 954-529-7899