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General NPI Number Information
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NPI Number | 1528257276
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Entity Type | Organization
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Legal Business Name | DEWHURST MEDICALSERVICES, INC.
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 1127 MERIDIAN AVE #7
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City | MIAMI BEACH
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State | FL
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Zip | 33139-4545
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Country | US
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Telephone | 786-573-3397
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Fax | 786-573-2367
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Provider Business Mailing Address
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Address Line | 1127 MERIDIAN AVE #7
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City | MIAMI BEACH
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State | FL
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Zip | 33139-4545
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Country | US
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Telephone | 786-573-3397
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Fax | 786-573-2367
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TYLER T DEWHURST
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Credential | ARNP
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Telephone | 786-573-3397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP3124292
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License Number State | FL
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