=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033172580
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICARDO ISRAEL GERENSTEIN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2006
-----------------------------------------------------
Last Update Date | 10/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1031 IVES DAIRY RD STE 228
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-2538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-467-6101
-----------------------------------------------------
Fax | 786-228-4644
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1031 IVES DAIRY RD STE 228
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-2538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-467-6101
-----------------------------------------------------
Fax | 786-228-4644
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | ME0081212
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------