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General NPI Number Information
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NPI Number | 1710038971
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Entity Type | Individual
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Provider Name | ROBERT M. GINGOLD M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1075 NE 125TH ST 101
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5800
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Country | US
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Telephone | 305-893-8111
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Fax | 305-895-6442
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Provider Business Mailing Address
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Address Line | 1075 NE 125TH ST 101
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5800
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Country | US
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Telephone | 305-893-8111
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Fax | 305-895-6442
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME036647
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License Number State | FL
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