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General NPI Number Information
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NPI Number | 1508225947
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Entity Type | Individual
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Provider Name | ANDREI P GHERGHINA DO, MS
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Gender | Male
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Dates
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Enumeration Date | 02/13/2016
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 10151 ENTERPRISE CTR STE 204
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3761
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Country | US
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Telephone | 561-405-3000
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Fax | 561-459-1444
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Provider Business Mailing Address
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Address Line | 10151 ENTERPRISE CTR STE 204
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3761
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Country | US
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Telephone | 561-405-3000
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Fax | 561-459-1444
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | UO4347
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | OS14108
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | OS14108
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License Number State | FL
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