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General NPI Number Information
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NPI Number | 1699568188
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Entity Type | Organization
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Legal Business Name | PHD MEDICAL PLLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 10155 COLLINS AVE
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City | BAL HARBOUR
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State | FL
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Zip | 33154-1655
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Country | US
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Telephone | 551-206-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 10155 COLLINS AVE
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City | BAL HARBOUR
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State | FL
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Zip | 33154-1655
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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 | OWNER
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Name | ABRAHAM KNOLL
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Credential | MD
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Telephone | 551-206-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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