=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225962111
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DILLON CHRISTIAN TATE EMT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2026
-----------------------------------------------------
Last Update Date | 06/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 MACARTHUR CSWY
-----------------------------------------------------
City | MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33139-5101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-406-1584
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 MACARTHUR CSWY
-----------------------------------------------------
City | MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33139-5101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-406-1584
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 146N00000X
-----------------------------------------------------
Taxonomy Name | Basic Emergency Medical Technician
-----------------------------------------------------
License Number | E3913716
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------