MEDICARE: DTMB CONSULTANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1023430980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DTMB CONSULTANS

Provider Business Mailing Address
First Line	:	455 NE 5TH AVE
Second Line	:	SUITE D115
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5658
Country	:	US
Telephone Number	:	732-882-8982
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 NE 8TH AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5745
Country	:	US
Telephone Number	:	561-274-2700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MITCHELL LAWRENCE BOWN
Credential	:
Telephone Number	:	732-882-8982

Provider Enumeration Date	:	01/13/2014
Last Update Date	:	01/13/2014

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Directions to “DTMB CONSULTANS ” Practice Location

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