Provider Demographics
NPI:1104227768
Name:CHAR DUMAIS AP, DOM INC
Entity type:Organization
Organization Name:CHAR DUMAIS AP, DOM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:MINEAR
Authorized Official - Last Name:DUMAIS
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:239-425-5477
Mailing Address - Street 1:17490 SABAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33917-2231
Mailing Address - Country:US
Mailing Address - Phone:239-425-5477
Mailing Address - Fax:
Practice Address - Street 1:13180 N CLEVELAND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-6200
Practice Address - Country:US
Practice Address - Phone:239-425-5477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1562171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty