Basic Information
Provider Information
NPI: 1528301330
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GROBMAN
FirstName: ARIEL
MiddleName: B
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 15280 NW 79TH CT STE 200
Address2:  
City: MIAMI LAKES
State: FL
PostalCode: 330165873
CountryCode: US
TelephoneNumber: 3055583724
FaxNumber: 7869074485
Practice Location
Address1: 3661 S MIAMI AVE STE 409
Address2:  
City: MIAMI
State: FL
PostalCode: 331334230
CountryCode: US
TelephoneNumber: 9058545971
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/29/2013
LastUpdateDate: 09/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207YX0901XME136077FLN Allopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
207Y00000XME136077FLY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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