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General NPI Number Information
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NPI Number | 1477194470
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Entity Type | Individual
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Provider Name | KARL HENRY DORMEVIL APRN
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Gender | Male
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 2465 S STATE ROAD 7 STE 800
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City | WELLINGTON
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State | FL
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Zip | 33414-9348
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Country | US
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Telephone | 561-784-4930
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Fax | 833-625-1635
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Provider Business Mailing Address
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Address Line | 3315 GROVE RD
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-1664
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Country | US
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Telephone | 561-704-8352
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11038892
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License Number State | FL
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