Healthcare Provider Details

I. General information

NPI: 1780844522
Provider Name (Legal Business Name): MICHAEL JONATHAN MARGOLIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NE 213TH ST STE 1006
AVENTURA FL
33180-1266
US

IV. Provider business mailing address

2801 NE 213TH ST STE 1006
AVENTURA FL
33180-1266
US

V. Phone/Fax

Practice location:
  • Phone: 954-452-9922
  • Fax: 575-437-3947
Mailing address:
  • Phone: 954-452-9922
  • Fax: 575-437-3947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD2013-0813
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: