Provider Demographics
NPI:1740361047
Name:MACINTYRE, DUGALD S (MD)
Entity type:Individual
Prefix:
First Name:DUGALD
Middle Name:S
Last Name:MACINTYRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DUGALD
Other - Middle Name:STEWART
Other - Last Name:MACINTYRE
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:182 SHORE DR S
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2616
Mailing Address - Country:US
Mailing Address - Phone:305-854-4357
Mailing Address - Fax:305-854-3632
Practice Address - Street 1:182 SHORE DR S
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2616
Practice Address - Country:US
Practice Address - Phone:305-854-4357
Practice Address - Fax:305-854-3632
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0022853207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP 00058509OtherMEDICARE RR
FL055862100Medicaid
FL92233OtherBC/BS
FL59274OtherAVMED