MEDICARE: DR DAN PLASTIC SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician

General Provider Information

NPI Number	:	1760911796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR DAN PLASTIC SURGERY

Provider Business Mailing Address
First Line	:	PO BOX 4651
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33338-4651
Country	:	US
Telephone Number	:	954-991-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2122 NW 62ND ST STE 229
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1858
Country	:	US
Telephone Number	:	954-991-8200
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. DAN GEORGESCU
Credential	:	MD
Telephone Number	:	954-681-3401

Provider Enumeration Date	:	06/04/2017
Last Update Date	:	07/24/2021

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