MEDICARE: KARL ENSELBERG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	ME15838	FL

General Provider Information

NPI Number	:	1326279241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL ENSELBERG M.D.

Provider Business Mailing Address
First Line	:	1560 ROYAL PALM WAY
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432
Country	:	US
Telephone Number	:	561-789-9517
Fax Number	:	561-391-8552

Provider Business Practice Location Address
First Line	:	1560 ROYAL PALM WAY
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-7543
Country	:	US
Telephone Number	:	561-789-9517
Fax Number	:	561-391-8552

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	07/28/2009

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