Healthcare Provider Details

I. General information

NPI: 1053355701
Provider Name (Legal Business Name): MEHMET FATIH GOKHAN HEPGUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E SAMPLE RD
DEERFIELD BEACH FL
33064-3502
US

IV. Provider business mailing address

1700 NW 49TH ST STE 125
FORT LAUDERDALE FL
33309-3750
US

V. Phone/Fax

Practice location:
  • Phone: 954-786-6460
  • Fax: 954-786-7304
Mailing address:
  • Phone: 954-786-6460
  • Fax: 954-786-7304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA115019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: