Gruzmark, Mitchell

Gruzmark, Mitchell is an individual health care provider with primary practice located at 4410 W 16Th Ave Ste 52 , Hialeah FL 33012-7193. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Gruzmark, Mitchell can be contacted via phone (305) 825-9899.

Contact Information

Primary practice address
4410 W 16Th Ave Ste 52 Hialeah FL 33012-7193
Phone: (305) 825-9899
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019030822 Illinois
Dental Providers / Pediatric Dentistry 1223P0221X DN24566 Florida

Profile Details

NPI number 1790138774
LBN Legal business name Gruzmark, Mitchell
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2016
Last updated Dec 20th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1790138774 NPPES
Florida MEDICAID 114189300

Popular Providers