Healthcare Provider Details

I. General information

NPI: 1417189549
Provider Name (Legal Business Name): MICHAEL GINSBURG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST STE 702
MIAMI FL
33136-2118
US

IV. Provider business mailing address

PO BOX 220
MCHENRY IL
60051-0220
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-2067
  • Fax: 305-243-1979
Mailing address:
  • Phone: 815-759-0800
  • Fax: 815-759-2367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME139489
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number036130514
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number71181-20
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number01089216A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036130514
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: