Healthcare Provider Details

I. General information

NPI: 1508815119
Provider Name (Legal Business Name): GABOR IMRE FERENCZY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 N PINE ISLAND RD STE 106
PLANTATION FL
33322
US

IV. Provider business mailing address

1776 N PINE ISLAND RD STE 106
PLANTATION FL
33322-5200
US

V. Phone/Fax

Practice location:
  • Phone: 954-376-3739
  • Fax: 844-407-9213
Mailing address:
  • Phone: 954-376-3739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME81219
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME81219
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: