Provider Demographics
NPI:1891000543
Name:NASSBERG DIABETES ASSOCIATES INC
Entity type:Organization
Organization Name:NASSBERG DIABETES ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMHI-GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-491-1000
Mailing Address - Street 1:5333 N DIXIE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3454
Mailing Address - Country:US
Mailing Address - Phone:954-491-1000
Mailing Address - Fax:954-938-7923
Practice Address - Street 1:5333 N DIXIE HWY STE 205
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3454
Practice Address - Country:US
Practice Address - Phone:954-491-1000
Practice Address - Fax:954-938-7923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9365653OtherLICENSE
FLARNP9334557OtherMEDICAL LICENSE NUMBER
FL1508572736OtherNATIONAL PROVIDER ID
FL1962857540OtherNATIONAL PROVIDER ID
FLME16517OtherMEDICAL LICENSE
FL1538301437OtherNATIONAL PROVIDER ID
FL1215363593OtherNATIONAL PROVIDER ID
FLAPRN11024379OtherMEDICAL LICENSE NUMBER
FLAPRN11010956OtherMEDICAL LICENSE NUMBER
FL1154911980OtherNATIONAL PROVIDER ID
FL122413400OtherNATIONAL PROVIDER ID
SC1710957832OtherNATIONAL PROVIDER
FLRN9490906OtherRN LICENSE