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General NPI Number Information
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NPI Number | 1730153016
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Entity Type | Individual
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Provider Name | LAURENCE I DORMAN DPM
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 9570 SW 107TH AVE SUITE 103
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City | MIAMI
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State | FL
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Zip | 33176-2788
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Country | US
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Telephone | 305-271-1564
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Fax | 305-271-5079
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Provider Business Mailing Address
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Address Line | 8200 NW 27 ST STE 108
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City | DORAL
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State | FL
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Zip | 33122-1906
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Country | US
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Telephone | 786-662-3893
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Fax | 786-660-3899
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO1226
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License Number State | FL
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