Provider Demographics
NPI:1528442092
Name:DUMAS, JEAN-ROBERT (MT)
Entity type:Individual
Prefix:
First Name:JEAN-ROBERT
Middle Name:
Last Name:DUMAS
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6801
Mailing Address - Country:US
Mailing Address - Phone:954-505-7301
Mailing Address - Fax:954-505-7302
Practice Address - Street 1:115 S 17TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6801
Practice Address - Country:US
Practice Address - Phone:954-505-7301
Practice Address - Fax:954-505-7302
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246QC1000X, 246QH0000X, 246QM0900X, 247200000X, 247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
No246QC1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyChemistry
No246QH0000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyHematology
No246QM0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMicrobiology
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other