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General NPI Number Information
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NPI Number | 1992149355
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Entity Type | Individual
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Provider Name | FELIX GRUDSKY
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Gender | Male
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 2801 NE 213TH ST STE 101100
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City | AVENTURA
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State | FL
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Zip | 33180-1263
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Country | US
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Telephone | 305-466-7333
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Fax | 786-651-2177
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Provider Business Mailing Address
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Address Line | 2801 NE 213TH ST STE 101100
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City | AVENTURA
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State | FL
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Zip | 33180-1263
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Country | US
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Telephone | 305-466-7333
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Fax | 786-651-2177
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS17040
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License Number State | FL
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