Provider Demographics
NPI:1740409911
Name:RESNIK DERMATOLOGY AVENTURA, PA
Entity Type:Organization
Organization Name:RESNIK DERMATOLOGY AVENTURA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:I
Authorized Official - Last Name:RESNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-692-8998
Mailing Address - Street 1:21097 NE 27TH CT STE 580
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1246
Mailing Address - Country:US
Mailing Address - Phone:305-692-8998
Mailing Address - Fax:305-692-8606
Practice Address - Street 1:21097 NE 27TH CT STE 580
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1246
Practice Address - Country:US
Practice Address - Phone:305-692-8998
Practice Address - Fax:305-692-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF26996Medicare UPIN