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NPI Code Detail

MEDICARE: DR. SIBDAS MUKHERJEE MUKHOPADHYAY M.D.

MEDICARE: DR. SIBDAS MUKHERJEE MUKHOPADHYAY M.D.
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
1174400000XSpecialist172503NY
2207VG0400XGynecology PhysicianME142611FL

Other Identifiers

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

General Provider Information

NPI Number : 1245238179
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIBDAS MUKHERJEE MUKHOPADHYAY M.D.
Provider Business Mailing Address
First Line : 14750 NW 77TH CT STE 106
Second Line :
City : MIAMI LAKES
State : FL
Zip : 33016-1507
Country : US
Telephone Number : 305-698-4000
Fax Number : 305-698-4014
Provider Business Practice Location Address
First Line : 14750 NW 77TH CT STE 106
Second Line :
City : MIAMI LAKES
State : FL
Zip : 33016-1507
Country : US
Telephone Number : 305-698-4000
Fax Number : 305-698-4014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 05/18/2021

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