Healthcare Provider Details

I. General information

NPI: 1184652430
Provider Name (Legal Business Name): BARRY GELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 12TH AVE BOX 016960 M851
MIAMI FL
33101-6960
US

IV. Provider business mailing address

1601 NW 12TH AVE BOX 016960 M851
MIAMI FL
33101-6960
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-4029
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-243-4029
  • Fax: 305-243-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberME64706
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: