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General NPI Number Information
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NPI Number | 1164712048
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Entity Type | Organization
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Legal Business Name | MISHA DENHAM, DO PA
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 2695 S LE JEUNE RD SUITE 203
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City | CORAL GABLES
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State | FL
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Zip | 33134-5839
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Country | US
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Telephone | 305-672-8559
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Fax | 305-672-9259
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Provider Business Mailing Address
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Address Line | 2695 S LE JEUNE RD SUITE 203
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City | CORAL GABLES
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State | FL
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Zip | 33134-5839
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Country | US
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Telephone | 305-672-8559
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Fax | 305-672-9259
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISHA DENHAM
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Credential | DO
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Telephone | 305-672-8559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | OS9157
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License Number State | FL
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