Healthcare Provider Details

I. General information

NPI: 1851398937
Provider Name (Legal Business Name): DAVID C. BLUMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 SW 2ND AVE STE 204
GAINESVILLE FL
32601-1216
US

IV. Provider business mailing address

720 SW 2ND AVE STE 204
GAINESVILLE FL
32601-1216
US

V. Phone/Fax

Practice location:
  • Phone: 352-372-1878
  • Fax: 352-372-7562
Mailing address:
  • Phone: 352-372-1878
  • Fax: 352-372-7562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME 30193
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: