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General NPI Number Information
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NPI Number | 1922448497
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Entity Type | Organization
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Legal Business Name | GOTLIN OBGYN & WELLNESS, P.A.
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 300 W 41ST ST STE 205
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3627
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Country | US
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Telephone | 305-280-0643
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Fax | 305-363-5541
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Provider Business Mailing Address
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Address Line | PO BOX 279191
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City | MIRAMAR
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State | FL
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Zip | 33027-9191
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Country | US
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Telephone | 786-320-5870
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Fax | 786-320-5871
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS LEE GOTLIN
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Credential | D.O.
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Telephone | 786-320-5870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1300011234
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License Number State | FL
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