Provider Demographics
NPI:1558300814
Name:DUSHAY, KEVIN M (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:DUSHAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2900 CORPORATE WAY STE D
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5603
Mailing Address - Fax:954-985-7073
Practice Address - Street 1:3501 JOHNSON ST FL 3
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5421
Practice Address - Country:US
Practice Address - Phone:401-444-3565
Practice Address - Fax:401-444-5493
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD11158207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020287700Medicaid