Healthcare Provider Details

I. General information

NPI: 1205832946
Provider Name (Legal Business Name): DINA BERNIE DUMERCY PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

IV. Provider business mailing address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-5724
  • Fax:
Mailing address:
  • Phone: 954-265-5724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS 36298
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: