Provider Demographics
NPI:1760443899
Name:DUPUY, SARGINE (MD)
Entity type:Individual
Prefix:
First Name:SARGINE
Middle Name:
Last Name:DUPUY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5607 NW 27TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-2826
Mailing Address - Country:US
Mailing Address - Phone:305-805-1700
Mailing Address - Fax:305-805-1715
Practice Address - Street 1:490 OPA LOCKA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-3563
Practice Address - Country:US
Practice Address - Phone:305-637-6400
Practice Address - Fax:305-636-5155
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79540208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258384400Medicaid
FL258384400Medicaid