Healthcare Provider Details

I. General information

NPI: 1992793731
Provider Name (Legal Business Name): MICHAEL CHARLES MARGULIES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR SUITE 704-E
MIAMI FL
33176-2148
US

IV. Provider business mailing address

8940 N KENDALL DR SUITE 704-E
MIAMI FL
33176-2148
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-0393
  • Fax: 305-595-0911
Mailing address:
  • Phone: 305-595-0393
  • Fax: 305-595-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME0023176
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: