Provider Demographics
NPI:1588694905
Name:GINSBERG, BRUCE (OD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:GINSBERG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 NE 163RD ST
Mailing Address - Street 2:
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160
Mailing Address - Country:US
Mailing Address - Phone:954-290-7676
Mailing Address - Fax:888-472-9066
Practice Address - Street 1:3745 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4104
Practice Address - Country:US
Practice Address - Phone:954-290-7676
Practice Address - Fax:888-472-9066
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2480152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078801501Medicaid
FL20293AMedicare PIN