Provider Demographics
NPI:1265604813
Name:EDWARD C. GELBER MDPA
Entity type:Organization
Organization Name:EDWARD C. GELBER MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:GELBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-326-0260
Mailing Address - Street 1:619 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-3609
Mailing Address - Country:US
Mailing Address - Phone:305-326-0260
Mailing Address - Fax:305-326-1709
Practice Address - Street 1:619 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-3609
Practice Address - Country:US
Practice Address - Phone:305-326-0260
Practice Address - Fax:305-326-1709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 25077207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1356305122OtherDOCTOR NPI
FL72763Medicare PIN