G DAVID ONSTAD MD PA
Osteopathic Medicine at 47 St, Fort Lauderdale, FL

License number
Florida ME19304
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: GORDON DAVID ONSTAD MD
Title: OWNER
Phone: (954) 491-9010
Address
Address
1960 NE 47Th St SUITE 105, Fort Lauderdale, FL 33308
National Provider ID: 1760408843
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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G. DAVID ONSTAD, M.D., PA

1960 NE 47 St SUITE 105, Fort Lauderdale, FL 33308

Status:
Inactive
Inactive reason:
Reinstatement
Registration:
Jun 1, 1980
Inactive since:
Oct 31, 2001
State ID:
672347
Business type:
Florida Profit Corporation
President, Treasurer, Directors:
G. David Onstad (President, Treasurer, Director), 1960 NE 47 St SUITE 105, Fort Lauderdale, FL 33308 (Physical),David G. Onstad President, Treasurer, Director, inactive
Agent:
G Onstad,1960 NE 47 St SUITE 105, Fort Lauderdale, FL 33308 (Physical)
EIN:
59-2001364

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