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General NPI Number Information
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NPI Number | 1497065882
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Entity Type | Organization
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Legal Business Name | GERSHWIN T BLYDEN MD PA
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 8335 NE 2ND AVE
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City | MIAMI
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State | FL
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Zip | 33138-3810
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Country | US
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Telephone | 305-757-0113
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Fax | 305-756-7485
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Provider Business Mailing Address
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Address Line | 8335 NE 2ND AVE
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City | MIAMI
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State | FL
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Zip | 33138-3810
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Country | US
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Telephone | 305-757-0113
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Fax | 305-756-7485
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Authorized Official
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Title or Position | M D
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Name | DR. GERSHWIN BLYDEN
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Credential |
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Telephone | 305-757-0113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0048415
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License Number State | FL
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