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General NPI Number Information
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NPI Number | 1588509442
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Entity Type | Organization
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Legal Business Name | IMD MINDCARE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 8321 NW 44TH CT
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City | LAUDERHILL
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State | FL
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Zip | 33351-5503
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Country | US
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Telephone | 954-245-1639
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Fax |
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Provider Business Mailing Address
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Address Line | 8321 NW 44TH CT
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City | LAUDERHILL
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State | FL
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Zip | 33351-5503
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Country | US
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Telephone | 954-245-1639
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | IDATUDE MERDELUS DUMAY
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Credential | APRN, PMHNP-C
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Telephone | 954-245-1639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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