Healthcare Provider Details

I. General information

NPI: 1306930953
Provider Name (Legal Business Name): IRVING ESTRIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 WEST SAMPLE ROAD RAND EYE INSTITUTE
POMPANO BEACH FL
33064-3542
US

IV. Provider business mailing address

5 WEST SAMPLE ROAD RAND EYE INSTITUTE
POMPANO BEACH FL
33064-3542
US

V. Phone/Fax

Practice location:
  • Phone: 954-782-1700
  • Fax:
Mailing address:
  • Phone: 954-782-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0038361
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME38361
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: