Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME0052072 | FL |
NPI | 1053374017 |
---|---|
Provider Name | Margaret J Gorensek |
First Address | Ft Lauderdale, FL 33334-7718 |
Second Address | Ft Lauderdale, FL 33304-3640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 26/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
049376700 | (05) | FL |
D61157 | (02) | FL |