Healthcare Provider Details

I. General information

NPI: 1417919291
Provider Name (Legal Business Name): DARYL GERSHBEIN DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3095 NW 7TH ST
MIAMI FL
33125-4241
US

IV. Provider business mailing address

3095 NW 7TH ST
MIAMI FL
33125-4241
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-4044
  • Fax: 305-642-2320
Mailing address:
  • Phone: 305-642-4044
  • Fax: 305-642-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO 2103
License Number StateFL

VIII. Authorized Official

Name: DARYL M GERSHBEIN
Title or Position: OWNER
Credential: D.P.M.
Phone: 305-642-4044