Organization
BRUCE P DORMAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE P DORMAN MD (OWNER)
(941) 714-0276
Entity
Organization
Contact information
Practice address
311 MANATEE AVE E, BRADENTON, FL 34208-1933
(941) 714-0276
(941) 714-0294
Mailing address
311 MANATEE AVE E, BRADENTON, FL 34208-1933
(941) 714-0276
(941) 714-0294
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME68759
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP6082
RAILROAD MEDICARE
FL
01
—
ME68759
STATE LICENSE NUMBER
FL
Enumeration date
08/06/2009
Last updated
01/28/2010
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