Provider Demographics
NPI:1386242220
Name:DORT, LUCILE CINDY (DPT)
Entity type:Individual
Prefix:DR
First Name:LUCILE
Middle Name:CINDY
Last Name:DORT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LUCILE
Other - Middle Name:CINDY
Other - Last Name:CADET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1077 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-2998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1077 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-2998
Practice Address - Country:US
Practice Address - Phone:561-676-7357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist