Provider Demographics
NPI:1538577408
Name:DUMORNE, NADERGE (MD)
Entity type:Individual
Prefix:
First Name:NADERGE
Middle Name:
Last Name:DUMORNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NADERGE
Other - Middle Name:
Other - Last Name:DUMORNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 25487
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2487
Mailing Address - Country:US
Mailing Address - Phone:941-202-5342
Mailing Address - Fax:941-202-5342
Practice Address - Street 1:4401 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3142
Practice Address - Country:US
Practice Address - Phone:941-357-5550
Practice Address - Fax:419-792-7152
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine