Provider Demographics
NPI:1891000543
Name:NASSBERG DIABETES ASSOCIATES INC
Entity Type:Organization
Organization Name:NASSBERG DIABETES ASSOCIATES INC
Other - Org Name:NASSBERG DIABETES ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMHI-GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-491-1000
Mailing Address - Street 1:5333 N DIXIE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3454
Mailing Address - Country:US
Mailing Address - Phone:954-491-1000
Mailing Address - Fax:954-938-7923
Practice Address - Street 1:5333 N DIXIE HWY STE 205
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3454
Practice Address - Country:US
Practice Address - Phone:954-491-1000
Practice Address - Fax:954-938-7923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME16517OtherMEDICAL LICENSE
FLRN9490906OtherRN LICENSE
FL1215363593OtherNATIONAL PROVIDER ID
SC1710957832OtherNATIONAL PROVIDER
FL1538301437OtherNATIONAL PROVIDER ID
FL9365653OtherLICENSE
FL1508572736OtherNATIONAL PROVIDER ID