Provider Demographics
NPI:1427070028
Name:DR. H WASSERMAN PA
Entity type:Organization
Organization Name:DR. H WASSERMAN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WASSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-672-3375
Mailing Address - Street 1:960 ARTHUR GODFREY RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3326
Mailing Address - Country:US
Mailing Address - Phone:305-672-3375
Mailing Address - Fax:305-672-2233
Practice Address - Street 1:960 ARTHUR GODFREY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3326
Practice Address - Country:US
Practice Address - Phone:305-672-3375
Practice Address - Fax:305-672-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCHOOO6423111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22935OtherBLUE CROSS BLUE SHIED
FL22935Medicare ID - Type Unspecified