Provider Demographics
NPI:1952654543
Name:MPN MEDICAL CENTER OF DUNDEE
Entity Type:Organization
Organization Name:MPN MEDICAL CENTER OF DUNDEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAMRATA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-439-8000
Mailing Address - Street 1:1023 DUNDEE ROAD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884
Mailing Address - Country:US
Mailing Address - Phone:863-439-8000
Mailing Address - Fax:863-439-8020
Practice Address - Street 1:1023 DUNDEE ROAD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884
Practice Address - Country:US
Practice Address - Phone:863-439-8000
Practice Address - Fax:863-439-8020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDPROVIDERS NETWORK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5799207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty