MEDICARE: DR. DIMITRI MITCHEL GITELMAKER M.D.

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	207R00000X	Internal Medicine Physician	ME142875	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	:	1609020098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIMITRI MITCHEL GITELMAKER M.D.

Provider Business Mailing Address
First Line	:	200 SUNNY ISLES BLVD UNIT 305
Second Line	:
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-4399
Country	:	US
Telephone Number	:	732-266-1399
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 S OCEAN DR STE 230
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2930
Country	:	US
Telephone Number	:	732-266-1399
Fax Number	:	786-677-8797

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

Provider Enumeration Date	:	11/11/2008
Last Update Date	:	04/12/2023

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