NPIMap

Organization Active NPI

Rodolfo Dumenigo MD PA

  • General Practice Physician
  • Lakeland, FL
National Provider Identifier
1154901197
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
RODOLFO DUMENIGO MD PA
Practice address
2417 US Highway 98 N
Lakeland, FL 33805-2410
Phone
(863) 821-0030
NPI assigned
Apr 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jose D Suarez
Title
Cmo
Phone
(305) 534-0076

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

2417 US Highway 98 N
Lakeland, FL 33805-2410

Mailing address

1400 NW 107TH Ave Ste 500
Sweetwater, FL 33172-2746
Phone (305) 534-0076

Other practice location 1

205 1st St S Ste A
Winter Haven, FL 33880-3204
Phone (305) 534-0076

Other names 1

  • CLINICAL CARE MEDICAL CENTERS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clinical Care Medical Centers20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1154901197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW 107TH AVE STE 500",
            "city": "SWEETWATER",
            "state": "FL",
            "postal_code": "331722746",
            "telephone_number": "305-534-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052410",
            "telephone_number": "863-821-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 1st St S Ste A",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338803204",
            "country_code": "US",
            "telephone_number": "305-534-0076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RODOLFO DUMENIGO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "SUAREZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "305-534-0076"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICAL CARE MEDICAL CENTERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.