Individual
MR. JONATHAN THOMAS DISMUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
6804 CECELIA DR, NEW PORT RICHEY, FL 34653-4935
(855) 232-0644
(888) 546-0488
Mailing address
6804 CECELIA DR, NEW PORT RICHEY, FL 34653-4935
(855) 232-0644
(888) 546-0488
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11002313
FL
363LG0600X
Gerontology Nurse Practitioner
APRN11002313
FL
Other
Enumeration date
06/10/2019
Last updated
02/08/2021
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