Provider Demographics
NPI:1184688657
Name:NUSBAUM, BERNARD P (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:P
Last Name:NUSBAUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4425 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1837
Mailing Address - Country:US
Mailing Address - Phone:305-448-9100
Mailing Address - Fax:330-544-8105
Practice Address - Street 1:4425 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1837
Practice Address - Country:US
Practice Address - Phone:305-448-9100
Practice Address - Fax:305-448-9100
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2014-08-26
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Provider Licenses
StateLicense IDTaxonomies
FLME37143207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63739Medicare UPIN