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General NPI Number Information
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NPI Number | 1972929792
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Entity Type | Individual
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Provider Name | ARON GREGORY NUSBAUM M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4425 PONCE DE LEON BLVD STE 230
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City | CORAL GABLES
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State | FL
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Zip | 33146-1871
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Country | US
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Telephone | 305-448-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 1581 BRICKELL AVE
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City | MIAMI
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State | FL
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Zip | 33129-1215
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Country | US
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Telephone | 305-610-5316
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Fax |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME131158
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License Number State | FL
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