Healthcare Provider Details
I. General information
NPI: 1124084413
Provider Name (Legal Business Name): MICHAEL DAVID HELLINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/25/2006
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2600 SW 3RD AVE STE 650
MIAMI FL
33129-2338
US
IV. Provider business mailing address
2600 SW 3RD AVE STE 650
MIAMI FL
33129-2338
US
V. Phone/Fax
- Phone: 305-858-1515
- Fax: 305-859-9531
- Phone: 305-858-1515
- Fax: 305-859-9531
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | ME56722 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: