Healthcare Provider Details

I. General information

NPI: 1801527908
Provider Name (Legal Business Name): HANNAH GUMAER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17035 SW 93RD ST APT 5-102
MIAMI FL
33196-1176
US

IV. Provider business mailing address

17035 SW 93RD ST APT 5-102
MIAMI FL
33196-1176
US

V. Phone/Fax

Practice location:
  • Phone: 845-820-2921
  • Fax:
Mailing address:
  • Phone: 845-820-2921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: