Provider Demographics
NPI:1902916117
Name:TUMMINIA, LOUIS GERARD (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:GERARD
Last Name:TUMMINIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 LINTON BLVD
Mailing Address - Street 2:SUITE E2
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6596
Mailing Address - Country:US
Mailing Address - Phone:561-498-8891
Mailing Address - Fax:561-498-8031
Practice Address - Street 1:5130 LINTON BLVD
Practice Address - Street 2:SUITE E2
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6596
Practice Address - Country:US
Practice Address - Phone:561-498-8891
Practice Address - Fax:561-498-8031
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL144403OtherVYTRA
FLK5767OtherMEDICARE GROUP PIN
FL110247480OtherRAILROAD MEDICARE
FL46792OtherBLUE CROSS BLUE SHIELD OF FLA
FL46792OtherBLUE CROSS BLUE SHIELD OF FLA
FLK5767OtherMEDICARE GROUP PIN