Registration – Miaminice

Doctor Registration

Complete the form below and submit payment to confirm your attendance to Miami Nice 2024.

Remember you can choose Saturday, Sunday or both dates this year.

Payments through PayPal will say Donation to MDOPA.

Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

FL License Number (If Applicable)

OE Tracker *

Don’t know your OE Tracker number? Click HERE

My Special Meal Requirements are: *

Please select the option that best applies (all memberships will be verified): *

Total

$ 0.00

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