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General NPI Number Information
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NPI Number | 1134155294
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Entity Type | Individual
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Provider Name | MICHEL GUY VANDORMAEL MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 15600 NW 67TH AVE STE 301
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2176
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Country | US
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Telephone | 844-665-4827
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Fax | 877-807-0603
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Provider Business Mailing Address
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Address Line | 2000 NW 87TH AVE
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City | DORAL
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State | FL
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Zip | 33172-2654
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Country | US
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Telephone | 844-665-4827
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Fax | 866-523-6595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME87973
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME 87973
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME 87973
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License Number State | FL
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