Healthcare Provider Details

I. General information

NPI: 1679511174
Provider Name (Legal Business Name): SOPHIA ESTHER DEBEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20601 E. DIXIE HWY ORTHOPAEDIC SPECIALISTS OF MIAMI BEACH
AVENTURA FL
33180
US

IV. Provider business mailing address

20604 E. DIXIE HWY ORTHOPAEDIC SPECIALISTS OF MIAMI BEACH
AVENTURA FL
33180
US

V. Phone/Fax

Practice location:
  • Phone: 786-923-3000
  • Fax: 786-565-9446
Mailing address:
  • Phone: 786-923-3000
  • Fax: 786-565-9446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberC55008
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberME100477
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number200701541
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: