Healthcare Provider Details

I. General information

NPI: 1922722974
Provider Name (Legal Business Name): DUMEDIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 2 ORIENTE MZA 23A LOT. 4 CASA7 COL. VILLAS TULUM
TULUM QUINTANA ROO
77780
MX

IV. Provider business mailing address

PO BOX 11198
FORT LAUDERDALE FL
33339-1198
US

V. Phone/Fax

Practice location:
  • Phone: 984-168-4065
  • Fax:
Mailing address:
  • Phone: 954-903-7445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL DUPRAT
Title or Position: CEO
Credential:
Phone: 954-526-9751