Healthcare Provider Details

I. General information

NPI: 1881964864
Provider Name (Legal Business Name): HAROLD EDWARD GARBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 SAN MARCO DR
FORT LAUDERDALE FL
33301-2547
US

IV. Provider business mailing address

605 SAN MARCO DR
FORT LAUDERDALE FL
33301-2547
US

V. Phone/Fax

Practice location:
  • Phone: 954-562-5831
  • Fax:
Mailing address:
  • Phone: 954-562-5831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberME 17953
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME 17953
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: