Healthcare Provider Details

I. General information

NPI: 1710970322
Provider Name (Legal Business Name): GARY N ACKERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 BURNS RD STE 101
PALM BEACH GARDENS FL
33410-4360
US

IV. Provider business mailing address

PO BOX 20800
BELFAST ME
04915-4105
US

V. Phone/Fax

Practice location:
  • Phone: 561-845-6000
  • Fax: 561-845-6916
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberME0054822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: