Provider Demographics
NPI:1164174520
Name:FEDEROFF, HOWARD JOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JOSHUA
Last Name:FEDEROFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3156 SW 27TH AVE UNIT 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4700
Mailing Address - Country:US
Mailing Address - Phone:240-281-2598
Mailing Address - Fax:
Practice Address - Street 1:3161 CENTER ST # 203
Practice Address - Street 2:
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-4608
Practice Address - Country:US
Practice Address - Phone:240-281-2598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME154543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine