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General NPI Number Information
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NPI Number | 1346001807
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Entity Type | Organization
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Legal Business Name | GORENSEK LLC
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 2151 E COMMERCIAL BLVD STE 203
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3807
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Country | US
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Telephone | 954-292-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 936 INTRACOASTAL DR APT 19AB
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3640
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Country | US
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Telephone | 954-292-2020
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MARGARET GORENSEK
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Credential | MD
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Telephone | 954-292-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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