MEDICARE: DR. REUVEN BROMBERG MD

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	2080P0216X	Pediatric Rheumatology Physician	ME111299	FL
2	207RR0500X	Rheumatology Physician	ME111299	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	:	1487856571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REUVEN BROMBERG MD

Provider Business Mailing Address
First Line	:	715 SW 73RD AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2635
Country	:	US
Telephone Number	:	305-250-9998
Fax Number	:	305-250-9975

Provider Business Practice Location Address
First Line	:	715 SW 73RD AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2635
Country	:	US
Telephone Number	:	305-250-9998
Fax Number	:	305-250-9975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	06/27/2019

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