Individual
WILSON DUMORNAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4101 S. HOSPITAL DRIVE, SUITE 14, PLANTATION, FL 33317-2857
(954) 368-3348
(954) 900-4720
Mailing address
4101 S. HOSPITAL DRIVE, SUITE 14, PLANTATION, FL 33317-2857
(954) 368-3348
(954) 900-4720
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
68723
GA
207YS0123X
Facial Plastic Surgery Physician
Primary
ME96799
FL
261QA1903X
Ambulatory Surgical Clinic/Center
68723
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68723
GEORGIA MEDICAL LICENSE
GA
01
—
ME 96799
FLORIDA MEDICAL LICENSE
FL
Enumeration date
10/10/2006
Last updated
03/07/2023
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