Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | OS14108 | FL |
N | 207N00000X | Dermatologist | UO4347 | FL |
Y | 207ND0101X | MOHS-Micrographic Surgeon | OS14108 | FL |
NPI | 1508225947 |
---|---|
Provider Name | Dr. Andrei P Gherghina |
First Address | Boynton Beach, FL 33437-3761 |
Second Address | Boynton Beach, FL 33437-3761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2016 |
Last Update Date | 28/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
JN916 | PTAN (01) | FL |