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General NPI Number Information
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NPI Number | 1609020098
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Entity Type | Individual
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Provider Name | DIMITRI MITCHEL GITELMAKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 3800 S OCEAN DR STE 230
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City | HOLLYWOOD
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State | FL
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Zip | 33019-2930
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Country | US
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Telephone | 732-266-1399
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Fax | 786-677-8797
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Provider Business Mailing Address
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Address Line | 200 SUNNY ISLES BLVD UNIT 305
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-4399
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Country | US
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Telephone | 732-266-1399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME142875
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License Number State | FL
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