Healthcare Provider Details

I. General information

NPI: 1881991438
Provider Name (Legal Business Name): GABRIEL LEMUEL SUNN FELSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GABRIEL LEMUEL SUNN FELSEN MD

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 MIAMI RD
FORT LAUDERDALE FL
33316-2933
US

IV. Provider business mailing address

PO BOX 22239
NEW YORK NY
10087-0001
US

V. Phone/Fax

Practice location:
  • Phone: 201-654-6397
  • Fax:
Mailing address:
  • Phone: 201-654-6397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME111641
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: