Healthcare Provider Details
I. General information
NPI: 1396949418
Provider Name (Legal Business Name): SILVERMAN, WENDER, KOONIN, EPSTEIN, GARCIA & ROZENCWAIG, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21000 NE 28TH AVE STE 104
AVENTURA FL
33180-1421
US
IV. Provider business mailing address
21000 NE 28TH AVE STE 104
AVENTURA FL
33180-1421
US
V. Phone/Fax
- Phone: 305-937-1999
- Fax: 305-931-2071
- Phone: 305-937-1999
- Fax: 305-931-2071
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081S0010X |
| Taxonomy | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEPHEN
S
WENDER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-937-1999