Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | ME146647 | FL |
NPI | 1063807170 |
---|---|
Provider Name | Dr. Carlos Dorta |
First Address | Royal Palm Beach, FL 33411-8315 |
Second Address | Atlantis, FL 33462-1149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 14/08/2020 |