Healthcare Provider Details

I. General information

NPI: 1699972653
Provider Name (Legal Business Name): DRS GRABOIS FIRESTONE AND LEBOW PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21110 BISCAYNE BLVD STE 312
AVENTURA FL
33180-1229
US

IV. Provider business mailing address

21110 BISCAYNE BLVD STE 312
AVENTURA FL
33180-1229
US

V. Phone/Fax

Practice location:
  • Phone: 305-933-3030
  • Fax: 305-933-1434
Mailing address:
  • Phone: 305-933-3030
  • Fax: 305-933-1434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME47978
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME43945
License Number StateFL

VIII. Authorized Official

Name: DR. B.MITCHELL GRABOIS
Title or Position: PRESIDENT
Credential: MD
Phone: 305-933-3030