Provider Demographics
NPI:1386987428
Name:DORLEAN, SANDY (APRN)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:
Last Name:DORLEAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:SANDY
Other - Middle Name:OLIVIER
Other - Last Name:TELFORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2711 SW 179TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5161
Mailing Address - Country:US
Mailing Address - Phone:305-401-0330
Mailing Address - Fax:
Practice Address - Street 1:5800 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-6102
Practice Address - Country:US
Practice Address - Phone:954-377-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA226756363LF0000X
FL9217319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily