1992774897 NPI number — DR. RUBEN DANIEL FELHANDLER DPM

Table of content: DR. RUBEN DANIEL FELHANDLER DPM (NPI 1992774897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992774897 NPI number — DR. RUBEN DANIEL FELHANDLER DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELHANDLER
Provider First Name:
RUBEN
Provider Middle Name:
DANIEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1992774897
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7441 WAYNE AVE
Provider Second Line Business Mailing Address:
APT 9J
Provider Business Mailing Address City Name:
MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33141-2534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-389-5851
Provider Business Mailing Address Fax Number:
305-820-6020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
935 W 49TH ST
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33012-3436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-356-5242
Provider Business Practice Location Address Fax Number:
305-820-6020
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  PO 3245 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 020504500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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