Provider Demographics
NPI:1891789467
Name:GREENHAWT, MICHAEL H (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:GREENHAWT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20950 NE 27TH CT
Mailing Address - Street 2:STE 203
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1232
Mailing Address - Country:US
Mailing Address - Phone:305-935-5960
Mailing Address - Fax:305-682-0449
Practice Address - Street 1:20950 NE 27TH CT
Practice Address - Street 2:STE 203
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1232
Practice Address - Country:US
Practice Address - Phone:305-935-5960
Practice Address - Fax:305-682-0449
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME22355207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037541100Medicaid
FL037541100Medicaid
92094Medicare ID - Type Unspecified