MEDICARE: DR. DAVID FINTAN GARAVAN M.D, PH.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
1	174400000X	Specialist	ME124500	FL

General Provider Information

NPI Number	:	1497202642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID FINTAN GARAVAN M.D, PH.D.

Provider Business Mailing Address
First Line	:	1228 WEST AVE
Second Line	:	314
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4381
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 WEST AVE
Second Line	:	314
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4381
Country	:	US
Telephone Number	:	305-833-7502
Fax Number	:

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

Provider Enumeration Date	:	09/06/2016
Last Update Date	:	09/06/2016

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