1275567406 NPI number — GELLER, HOROWITZ & AKHAVAN,PA

Table of content: (NPI 1275567406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275567406 NPI number — GELLER, HOROWITZ & AKHAVAN,PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GELLER, HOROWITZ & AKHAVAN,PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PODIATRY FOOT AND ANKLE SURGICAL GROUP OF SOUTH FLA.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275567406
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7000 W 12TH AVE
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-558-0444
Provider Business Mailing Address Fax Number:
305-557-3810

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7000 W 12TH AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-558-0444
Provider Business Practice Location Address Fax Number:
305-557-3810
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PENA
Authorized Official First Name:
EUNICE
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMIN
Authorized Official Telephone Number:
305-558-0444

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  PO3081 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X , with the licence number: PO2176 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: PO0849 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 390009600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 029763100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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