Provider Demographics
NPI:1992788301
Name:SCHWARTZBARD, ELLEN JOY (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:JOY
Last Name:SCHWARTZBARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6141 SUNSET DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5039
Mailing Address - Country:US
Mailing Address - Phone:305-667-4511
Mailing Address - Fax:335-667-0411
Practice Address - Street 1:6141 SUNSET DR
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5039
Practice Address - Country:US
Practice Address - Phone:305-667-4511
Practice Address - Fax:335-667-0411
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81975207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH47220Medicare UPIN
FL51259Medicare ID - Type Unspecified