Provider Demographics
NPI:1497705131
Name:DUMBACHER, PERRI L (MD)
Entity Type:Individual
Prefix:
First Name:PERRI
Middle Name:L
Last Name:DUMBACHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7560 RED BUG LAKE RD
Mailing Address - Street 2:SUITE 2048
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6591
Mailing Address - Country:US
Mailing Address - Phone:407-366-8856
Mailing Address - Fax:407-977-4319
Practice Address - Street 1:7560 RED BUG LAKE RD
Practice Address - Street 2:SUITE 2048
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6591
Practice Address - Country:US
Practice Address - Phone:407-366-8856
Practice Address - Fax:407-977-4319
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO43827207Q00000X
FLME60508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14927OtherBCBS
CO370235900Medicaid
FL370235900Medicaid
CO370235900Medicaid
FL370235900Medicaid
COF25665Medicare UPIN