Healthcare Provider Details

I. General information

NPI: 1851411391
Provider Name (Legal Business Name): JUSTIN C SPEIGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

8600 SW 92ND ST STE 204B
MIAMI FL
33156-7377
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-9404
  • Fax: 305-661-1510
Mailing address:
  • Phone: 305-928-7349
  • Fax: 305-630-3632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME114726
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: