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General NPI Number Information
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NPI Number | 1790110492
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Entity Type | Organization
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Legal Business Name | BAPTIST DIABETES ASSOCIATES, P.A.
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 7867 N KENDALL DR SUITE 80
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City | MIAMI
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State | FL
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Zip | 33156-7742
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Country | US
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Telephone | 305-595-8252
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Fax | 305-595-7958
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Provider Business Mailing Address
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Address Line | 7867 N KENDALL DR SUITE 80
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City | MIAMI
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State | FL
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Zip | 33156-7742
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Country | US
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Telephone | 305-595-8252
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Fax | 305-595-7958
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Authorized Official
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Title or Position | TREASURER
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Name | DR. MARTIN ROTHBERG
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Credential | M.D.
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Telephone | 305-613-8853
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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 | ME0014724
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License Number State | FL
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