Healthcare Provider Details

I. General information

NPI: 1952654543
Provider Name (Legal Business Name): MPN MEDICAL CENTER OF DUNDEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 DUNDEE ROAD
WINTER HAVEN FL
33884
US

IV. Provider business mailing address

1023 DUNDEE ROAD
WINTER HAVEN FL
33884
US

V. Phone/Fax

Practice location:
  • Phone: 863-439-8000
  • Fax: 863-439-8020
Mailing address:
  • Phone: 863-439-8000
  • Fax: 863-439-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS5799
License Number StateFL

VIII. Authorized Official

Name: NAMRATA AMIN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 863-439-8000