Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME58111 | FL |
NPI | 1003865213 |
---|---|
Provider Name | Rodolfo Dumenigo |
First Address | Sweetwater, FL 33172-2746 |
Second Address | Miami Beach, FL 33139-3810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 07/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11761R | MEDICARE (01) | FL |
374368300 | (05) | FL |
E79897 | (02) |