Healthcare Provider Details

I. General information

NPI: 1205765765
Provider Name (Legal Business Name): ABRAHAM JOSHUA EDELSTEIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5607 NW 27TH AVE STE 2
MIAMI FL
33142-2826
US

IV. Provider business mailing address

1800 N 42ND AVE
HOLLYWOOD FL
33021-4225
US

V. Phone/Fax

Practice location:
  • Phone: 305-805-1700
  • Fax: 305-805-1715
Mailing address:
  • Phone: 818-915-0779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: