Regine Dorvil, MD
General Practice in Port St Lucie, FL. Individual provider (NPI-1).
NPI number1043674880
StatusActive
Last updated in NPPESSep 14, 2022
Details
- NPI
- 1043674880
- Entity type
- Individual (NPI-1)
- Name
- Regine Dorvil
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 7, 2016
- Certification date
- Sep 14, 2022
- Last updated
- Sep 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | ACN1185 | FL | Yes |
| 208D00000X | General Practice | 81821 | GA |
Practice location
671 Se Port St Lucie BlvdPort St Lucie, FL 34984-5141
Phone 772-353-5716 · Fax 844-367-0091
Mailing address
1611 Nw 12th AveMiami, FL 33136-1005
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