Provider Demographics
NPI:1295078780
Name:ERIK VAN GINKEL MD PA
Entity type:Organization
Organization Name:ERIK VAN GINKEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN GINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-284-7736
Mailing Address - Street 1:7000 SW 62ND AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4716
Mailing Address - Country:US
Mailing Address - Phone:305-284-7736
Mailing Address - Fax:305-284-7571
Practice Address - Street 1:7000 SW 62ND AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4716
Practice Address - Country:US
Practice Address - Phone:305-284-7736
Practice Address - Fax:305-284-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50166261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty