Basic Information
Provider Information | |||||||||
NPI: | 1891721692 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ANAPOL | ||||||||
FirstName: | HOWARD | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1500 NW 12TH AVE | ||||||||
Address2: | JMT-EAST 1007 | ||||||||
City: | MIAMI | ||||||||
State: | FL | ||||||||
PostalCode: | 331361051 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3052434664 | ||||||||
FaxNumber: | 3052438470 | ||||||||
Practice Location | |||||||||
Address1: | 5513 MERRICK DRIVE | ||||||||
Address2: | SUITE #224 | ||||||||
City: | CORAL GABLES | ||||||||
State: | FL | ||||||||
PostalCode: | 331462531 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3052843333 | ||||||||
FaxNumber: | 3052438470 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/23/2006 | ||||||||
LastUpdateDate: | 02/15/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME61478 | FL | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 3713415-00 | 05 | FL |   | MEDICAID |