Basic Information
| Provider Information | |||||||||
| NPI: | 1679551212 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DWYER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 N MARTEL AVE | ||||||||
| Address2: | |||||||||
| City: | WEST HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900466611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234365019 | ||||||||
| FaxNumber: | 3233379142 | ||||||||
| Practice Location | |||||||||
| Address1: | 6405 N FEDERAL HWY | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333081412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547723627 | ||||||||
| FaxNumber: | 9547723766 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 02/19/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | OS10383 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207R00000X | OS10383 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.