MEDICARE: MR. JOHN PATRICK DWYER II CCT,RCS,RVT

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	246XS1301X	Sonography Specialist/Technologist Cardiovascular

General Provider Information

NPI Number	:	1942484019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN PATRICK DWYER II CCT,RCS,RVT

Provider Business Mailing Address
First Line	:	1050 NE 204 TERR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-2545
Country	:	US
Telephone Number	:	305-652-0363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 NE 204TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-2545
Country	:	US
Telephone Number	:	305-652-0363
Fax Number	:

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

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	12/24/2007

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