Healthcare Provider Details

I. General information

NPI: 1083108732
Provider Name (Legal Business Name): ERIC GINSBERG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2018
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5507 S CONGRESS AVE STE 130
ATLANTIS FL
33462-1139
US

IV. Provider business mailing address

5507 S CONGRESS AVE STE 130
ATLANTIS FL
33462-1139
US

V. Phone/Fax

Practice location:
  • Phone: 561-227-7660
  • Fax: 561-434-5165
Mailing address:
  • Phone: 561-227-7660
  • Fax: 561-434-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberOS22336
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: