Healthcare Provider Details

I. General information

NPI: 1841279163
Provider Name (Legal Business Name): ROISMAN & FLAM MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 SW 80TH ST SUITE 101
MIAMI FL
33143-4661
US

IV. Provider business mailing address

6601 SW 80TH ST SUITE 101
MIAMI FL
33143-4661
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-3316
  • Fax: 305-662-5736
Mailing address:
  • Phone: 305-661-3316
  • Fax: 305-662-5736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. RONALD FLAM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-661-3316