Provider Demographics
NPI:1932150554
Name:DYNAMIC MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:DYNAMIC MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-226-1721
Mailing Address - Street 1:8303 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3311
Mailing Address - Country:US
Mailing Address - Phone:305-226-1721
Mailing Address - Fax:
Practice Address - Street 1:8303 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3311
Practice Address - Country:US
Practice Address - Phone:305-226-1721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264031700Medicaid
FL24416OtherDMS BCBS PROV NO
FL686737Medicare Oscar/Certification
FL24416Medicare PIN
FL5412870001Medicare NSC
FL13199YMedicare ID - Type UnspecifiedQIAN MEDICARE
FL24416Medicare PIN
FLT55650Medicare UPIN
FLH65921Medicare UPIN
FL24416Medicare ID - Type UnspecifiedGACKSTETTERS MEDICARE
FL2619345OtherQIAN'S UHC MPIN
FL24416OtherDMS BCBS PROV NO
FLT54814Medicare UPIN