Healthcare Provider Details

I. General information

NPI: 1750338018
Provider Name (Legal Business Name): LUIS A GINART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 S. CONGRESS AVENUE ANNEX BUILDING
WEST PALM BEAC FL
33401-5107
US

IV. Provider business mailing address

1630 SW 96TH AVE
MIAMI FL
33165-7630
US

V. Phone/Fax

Practice location:
  • Phone: 561-274-3100
  • Fax: 561-837-5332
Mailing address:
  • Phone: 305-480-8614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number10144
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN133
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: