MEDICARE: DR. HENRY PICKETT DUMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME 0026677	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	48889U	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184627267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY PICKETT DUMAS MD

Provider Business Mailing Address
First Line	:	1033 DR MARTIN LUTHER KING JR ST N
Second Line	:	SUITE 108
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-1547
Country	:	US
Telephone Number	:	727-456-4250
Fax Number	:	727-346-1044

Provider Business Practice Location Address
First Line	:	615 E PRINCETON ST
Second Line	:	STE 400
City	:	ORLANDO
State	:	FL
Zip	:	32803-1469
Country	:	US
Telephone Number	:	407-894-8556
Fax Number	:	407-894-7689

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	02/03/2010

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