GGB MD PA
Osteopathic Medicine at 4 Ave, Fort Lauderdale, FL

License number
Florida ME99169
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: GEORGE G BOCTOR MD
Title: OWNER
Phone: (954) 522-8561
Address
Address
1503 SE 4Th Ave, Fort Lauderdale, FL 33316
National Provider ID: 1679813844
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GGB MD PA

Fort Lauderdale, FL

Industry:
Business Services at Non-Commercial Site, Medical Doctor's Office, Nonclassifiable Establishments
Registration:
Dec 10, 2012
Addresses:
4701 N Federal Hwy SUITE A#12, Fort Lauderdale, FL 33308 (Physical)
Fort Lauderdale, FL 33307 (Mailing)
14330 Jockey Cir N, Fort Lauderdale, FL 33330
PO Box 23158, Fort Lauderdale, FL 33307
State ID:
P12000100295
Business type:
Florida Profit Corporation
S:
George G Boctor (Secretary, Treasurer, Director, President),Vincent Pianelli Md, Pa inactive
Agent:
George Boctor,4701 N Federal Hwy SUITE A#12, Fort Lauderdale, FL 33308 (Physical)
EIN:
46-1532974

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