Provider Demographics
NPI:1568573756
Name:MEDICAL OFFICES OF SCOTT B HALPERIN PA
Entity Type:Organization
Organization Name:MEDICAL OFFICES OF SCOTT B HALPERIN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:HALPERIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-821-5261
Mailing Address - Street 1:7100 W 20TH AVENUE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1812
Mailing Address - Country:US
Mailing Address - Phone:305-821-5261
Mailing Address - Fax:305-821-5094
Practice Address - Street 1:7100 W 20TH AVENUE
Practice Address - Street 2:SUITE 213
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-821-5261
Practice Address - Fax:305-821-5094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047579207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056063400Medicaid
D50870Medicare UPIN
FL056063400Medicaid
03896Medicare PIN