Provider Demographics
NPI:1730916768
Name:DUMART AESTHETICS
Entity type:Organization
Organization Name:DUMART AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPOTE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-502-7730
Mailing Address - Street 1:469 LINDEN AVE S
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-0564
Mailing Address - Country:US
Mailing Address - Phone:786-502-7730
Mailing Address - Fax:
Practice Address - Street 1:469 LINDEN AVE S
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33974-0564
Practice Address - Country:US
Practice Address - Phone:786-502-7730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty