MEDICARE: DSM STAFFING, INC.

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	164W00000X	Licensed Practical Nurse	5223413	FL

General Provider Information

NPI Number	:	1609370410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DSM STAFFING, INC.

Provider Business Mailing Address
First Line	:	10665 SW 190TH ST STE 3202
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7654
Country	:	US
Telephone Number	:	786-732-6329
Fax Number	:	786-732-6329

Provider Business Practice Location Address
First Line	:	10665 SW 190TH ST STE 3202
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7654
Country	:	US
Telephone Number	:	786-732-6329
Fax Number	:	786-732-6329

Authorized Official
Title or Position	:	ALT ADMINITRATOR
Name	:	ANDRE HOLDING
Credential	:
Telephone Number	:	404-545-9880

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	03/19/2018

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