Provider Demographics
NPI:1417552407
Name:DUMINIE, ASHLEY
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:DUMINIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W BURLEIGH BLVD
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-2414
Mailing Address - Country:US
Mailing Address - Phone:352-343-1502
Mailing Address - Fax:
Practice Address - Street 1:550 W BURLEIGH BLVD
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-2414
Practice Address - Country:US
Practice Address - Phone:352-343-1502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist