MEDICARE: MISHA DENHAM, DO PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	OS9157	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164712048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISHA DENHAM, DO PA

Provider Business Mailing Address
First Line	:	2695 S LE JEUNE RD
Second Line	:	SUITE 203
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5839
Country	:	US
Telephone Number	:	305-672-8559
Fax Number	:	305-672-9259

Provider Business Practice Location Address
First Line	:	2695 S LE JEUNE RD
Second Line	:	SUITE 203
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5839
Country	:	US
Telephone Number	:	305-672-8559
Fax Number	:	305-672-9259

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISHA DENHAM
Credential	:	DO
Telephone Number	:	305-672-8559

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	01/17/2017

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Directions to “MISHA DENHAM, DO PA ” Practice Location

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