Healthcare Provider Details

I. General information

NPI: 1952305963
Provider Name (Legal Business Name): PAUL G FISHBEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 306W
MIAMI FL
33176-2131
US

IV. Provider business mailing address

8950 N KENDALL DR STE 506W
MIAMI FL
33176-2132
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-9966
  • Fax: 305-595-0282
Mailing address:
  • Phone: 305-595-2710
  • Fax: 305-274-9258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME34358
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: