Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME111299 | FL |
N | 2080P0216X | Pediatric Rheumatologist | ME111299 | FL |
NPI | 1487856571 |
---|---|
Provider Name | Dr. Reuven Bromberg |
First Address | Miami, FL 33144-2635 |
Second Address | Miami, FL 33144-2635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 27/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043116200 | (05) | FL |