Provider Demographics
NPI:1275567406
Name:GELLER, HOROWITZ & AKHAVAN,PA
Entity Type:Organization
Organization Name:GELLER, HOROWITZ & AKHAVAN,PA
Other - Org Name:PODIATRY FOOT AND ANKLE SURGICAL GROUP OF SOUTH FLA.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-558-0444
Mailing Address - Street 1:7000 W 12TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014
Mailing Address - Country:US
Mailing Address - Phone:305-558-0444
Mailing Address - Fax:305-557-3810
Practice Address - Street 1:7000 W 12TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:305-558-0444
Practice Address - Fax:305-557-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3081213E00000X
FLPO2176213E00000X
213E00000X
FLPO0849213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390009600Medicaid
FL029763100Medicaid
FLV06173Medicare UPIN
FLT86781Medicare UPIN
FLT55424Medicare UPIN
FLU7190Medicare ID - Type UnspecifiedDR. STEPHEN LEVINE
FL1070970001Medicare NSC
FL390009600Medicaid
FL72982Medicare PIN
FL029763100Medicaid