MEDICARE: DANIEL TENNENBAUM 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
1	208800000X	Urology Physician	ME162026	FL
2	2088P0231X	Pediatric Urology Physician	ME162026	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	:	1629509385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL TENNENBAUM M.D.

Provider Business Mailing Address
First Line	:	3200 SW 60TH CT STE 104
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4069
Country	:	US
Telephone Number	:	182-837-7107
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 SW 60TH CT STE 104
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4069
Country	:	US
Telephone Number	:	718-283-7710
Fax Number	:

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

Provider Enumeration Date	:	03/24/2017
Last Update Date	:	04/07/2026

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