Provider Demographics
NPI:1154593184
Name:HINDS, DIONNE LAYNE (MD)
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:LAYNE
Last Name:HINDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DIONNE
Other - Middle Name:ALLYSON
Other - Last Name:LAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 SE HILLMOOR DR STE C-106
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7551
Mailing Address - Country:US
Mailing Address - Phone:772-249-0636
Mailing Address - Fax:772-237-3114
Practice Address - Street 1:1801 SE HILLMOOR DR STE C-106
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7551
Practice Address - Country:US
Practice Address - Phone:772-249-0636
Practice Address - Fax:772-237-3114
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDA689ZMedicare PIN