=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306660642
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DMH HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2024
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8000 HAMPTON BLVD APT 307A
-----------------------------------------------------
City | NORTH LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33068-5628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-984-1300
-----------------------------------------------------
Fax | 561-288-0830
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8000 HAMPTON BLVD # A307
-----------------------------------------------------
City | NORTH LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33068-5615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-984-1300
-----------------------------------------------------
Fax | 561-288-0830
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | DUNSTAN M HENRY
-----------------------------------------------------
Credential | APRN, AGNP-C
-----------------------------------------------------
Telephone | 561-984-1300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------