Healthcare Provider Details

I. General information

NPI: 1154390904
Provider Name (Legal Business Name): EMEL ESENER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MEADOWS RD SUITE C
BOCA RATON FL
33486-2331
US

IV. Provider business mailing address

21754 CLUB VILLA TER
BOCA RATON FL
33433-3703
US

V. Phone/Fax

Practice location:
  • Phone: 561-416-8995
  • Fax:
Mailing address:
  • Phone: 561-417-7468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME61048
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: