MEDICARE: JEAN ROBERT DORESTIN APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	APRN11042345	FL

General Provider Information

NPI Number	:	1376415166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN ROBERT DORESTIN APRN

Provider Business Mailing Address
First Line	:	2880 W OAKLAND PARK BLVD STE 125E
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1362
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 W OAKLAND PARK BLVD STE 125E
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1362
Country	:	US
Telephone Number	:	954-871-9828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	09/22/2025

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