Healthcare Provider Details

I. General information

NPI: 1013463330
Provider Name (Legal Business Name): GBMT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 MEADOWS RD SUITE 311
BOCA RATON FL
33486-2349
US

IV. Provider business mailing address

875 MEADOWS ROAD SUITE 311
BOCA RATON FL
33486
US

V. Phone/Fax

Practice location:
  • Phone: 205-787-8676
  • Fax: 205-785-7944
Mailing address:
  • Phone: 205-787-8676
  • Fax: 205-785-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME114388
License Number StateFL

VIII. Authorized Official

Name: DR. RESIT CEM CEZAYIRLI
Title or Position: PRESIDENT
Credential: M.D
Phone: 205-787-8676