Provider Demographics
NPI:1306930953
Name:ESTRIN, IRVING (MD)
Entity type:Individual
Prefix:
First Name:IRVING
Middle Name:
Last Name:ESTRIN
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 1:5 WEST SAMPLE ROAD
Mailing Address - Street 2:RAND EYE INSTITUTE
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3542
Mailing Address - Country:US
Mailing Address - Phone:954-782-1700
Mailing Address - Fax:
Practice Address - Street 1:5 WEST SAMPLE ROAD
Practice Address - Street 2:RAND EYE INSTITUTE
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3542
Practice Address - Country:US
Practice Address - Phone:954-782-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038361174400000X
FLME38361207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61173ZMedicare ID - Type UnspecifiedDR. ESTRIN