Provider Demographics
NPI:1215337456
Name:DORT, ROSELOR
Entity type:Individual
Prefix:
First Name:ROSELOR
Middle Name:
Last Name:DORT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1681 BALFOUR POINT DR APT G
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1950
Mailing Address - Country:US
Mailing Address - Phone:561-601-8639
Mailing Address - Fax:
Practice Address - Street 1:1681 BALFOUR POINT DR APT G
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1950
Practice Address - Country:US
Practice Address - Phone:561-601-8639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT12935227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered