Healthcare Provider Details

I. General information

NPI: 1982885331
Provider Name (Legal Business Name): PHILIP F AVERBUCH MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9750 NW 33RD ST STE 116
CORAL SPRINGS FL
33065
US

IV. Provider business mailing address

9750 NW 33RD ST STE 116
CORAL SPRINGS FL
33065-4000
US

V. Phone/Fax

Practice location:
  • Phone: 954-722-0040
  • Fax: 954-344-7964
Mailing address:
  • Phone: 954-722-0040
  • Fax: 954-344-7964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP AVERBUCH
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D.
Phone: 954-722-0040