Provider Demographics
NPI:1841518107
Name:RHAISA A DUMENIGO MD LLC
Entity type:Organization
Organization Name:RHAISA A DUMENIGO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHAISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUMENIGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-389-2410
Mailing Address - Street 1:78 SW 13 AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:78 SW 13 AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135
Practice Address - Country:US
Practice Address - Phone:305-389-2410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1060332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty