Healthcare Provider Details

I. General information

NPI: 1487224572
Provider Name (Legal Business Name): JANET DIMECH CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 05/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29253 US HIGHWAY 19 N
CLEARWATER FL
33761-2102
US

IV. Provider business mailing address

7324 SOUTHWEST FWY STE 1550
HOUSTON TX
77074-2053
US

V. Phone/Fax

Practice location:
  • Phone: 713-779-9800
  • Fax:
Mailing address:
  • Phone: 713-779-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number143201
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: