Provider Demographics
NPI:1710929039
Name:CORNDORF, MAX ISAK (MD)
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:ISAK
Last Name:CORNDORF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 DOUGLAS ROAD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2087
Mailing Address - Country:US
Mailing Address - Phone:305-461-0212
Mailing Address - Fax:305-461-0208
Practice Address - Street 1:800 DOUGLAS ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2087
Practice Address - Country:US
Practice Address - Phone:305-461-0212
Practice Address - Fax:305-461-0208
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME95183207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAB720YMedicare PIN
B58519Medicare UPIN
FLAB720XMedicare PIN