Healthcare Provider Details

I. General information

NPI: 1619610078
Provider Name (Legal Business Name): DEENA WERDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9526 HARDING AVE
SURFSIDE FL
33154-2502
US

IV. Provider business mailing address

9526 HARDING AVE
SURFSIDE FL
33154-2502
US

V. Phone/Fax

Practice location:
  • Phone: 561-772-7355
  • Fax: 561-828-9257
Mailing address:
  • Phone: 561-772-7355
  • Fax: 561-828-9257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME163920
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: