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General NPI Number Information
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NPI Number | 1730485277
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Entity Type | Individual
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Provider Name | AVI GERSHON OPPENHEIMER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 2950 CLEVELAND CLINIC BLVD
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City | WESTON
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State | FL
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Zip | 33331-3609
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Country | US
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Telephone | 542-998-0539
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Fax |
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Provider Business Mailing Address
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Address Line | 22360 GUADELOUPE ST
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City | BOCA RATON
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State | FL
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Zip | 33433-4939
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Country | US
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Telephone | 954-299-8053
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME110466
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License Number State | FL
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