Healthcare Provider Details

I. General information

NPI: 1740478692
Provider Name (Legal Business Name): TUMMINIA INTERNAL MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 HAGEN RANCH RD STE B6
BOYNTON BEACH FL
33437-3723
US

IV. Provider business mailing address

10301 HAGEN RANCH RD STE B6
BOYNTON BEACH FL
33437-3723
US

V. Phone/Fax

Practice location:
  • Phone: 561-498-8031
  • Fax:
Mailing address:
  • Phone: 561-498-8031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS7926
License Number StateFL

VIII. Authorized Official

Name: DR. LOUIS G TUMMINIA
Title or Position: PRES
Credential:
Phone: 561-498-8891