Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME145155 | FL |
N | 2080P0204X | Pediatric Emergency Doctor | ME145155 | FL |
NPI | 1316355795 |
---|---|
Provider Name | Dania Rumbak |
First Address | Daytona Beach, FL 32114-2709 |
Second Address | Daytona Beach, FL 32114-2709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2014 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
108892600 | (05) | FL |