Healthcare Provider Details

I. General information

NPI: 1124057898
Provider Name (Legal Business Name): JEFFREY BARTON GELBLUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JEFF GELBLUM MD

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NE 213TH ST STE 1004
AVENTURA FL
33180-1265
US

IV. Provider business mailing address

9960 NW 116TH WAY STE 13
MEDLEY FL
33178-1175
US

V. Phone/Fax

Practice location:
  • Phone: 305-936-9393
  • Fax: 305-936-9650
Mailing address:
  • Phone: 786-924-1311
  • Fax: 786-924-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME49900
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: