Provider Demographics
NPI:1871984468
Name:DORCE, JENNIFER (DO)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DORCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:DORCE-MEDARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1250 SOUTHWINDS DR
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1459
Mailing Address - Country:US
Mailing Address - Phone:954-712-6356
Mailing Address - Fax:
Practice Address - Street 1:1250 SOUTHWINDS DR
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-1459
Practice Address - Country:US
Practice Address - Phone:561-582-5559
Practice Address - Fax:561-439-4384
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO 3491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine