MEDICARE: GUILHERME DABUS 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	2085R0202X	Diagnostic Radiology Physician	ME 106336	FL
2	2085R0202X	Diagnostic Radiology Physician	227379	MA
3	2085N0700X	Neuroradiology Physician	ME106336	FL

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

General Provider Information

NPI Number	:	1386602399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILHERME DABUS MD

Provider Business Mailing Address
First Line	:	PO BOX 198054
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-8054
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8950 N KENDALL DR STE 407W
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2132
Country	:	US
Telephone Number	:	786-596-3876
Fax Number	:	786-533-9989

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	02/27/2024

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