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General NPI Number Information
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NPI Number | 1184264764
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Entity Type | Individual
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Provider Name | GIRMA MOGES GAMME M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2020
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Last Update Date | 01/06/2023
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Provider Practice Location Address
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Address Line | DON SOFFER CLINICAL RESEARCH BUILDING 1120 NW 14TH STREET - 4TH FLOOR
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City | MIAMI
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State | FL
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Zip | 33136
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Country | US
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Telephone | 631-686-7679
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Fax | 631-686-6925
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Provider Business Mailing Address
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Address Line | 1120 NW 14TH ST FL 4
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City | MIAMI
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State | FL
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Zip | 33136-2107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 302170
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME159498
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License Number State | FL
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