Provider Demographics
NPI:1972929792
Name:NUSBAUM, ARON GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:ARON
Middle Name:GREGORY
Last Name:NUSBAUM
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 1:1581 BRICKELL AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1215
Mailing Address - Country:US
Mailing Address - Phone:305-610-5316
Mailing Address - Fax:
Practice Address - Street 1:4425 PONCE DE LEON BLVD STE 230
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1871
Practice Address - Country:US
Practice Address - Phone:305-448-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131158207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology