Provider Demographics
NPI:1043729569
Name:RENEE GASGARTH, M.D. P.A.
Entity Type:Organization
Organization Name:RENEE GASGARTH, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEA/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GASGARTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-617-9645
Mailing Address - Street 1:7300 SW 62ND PL STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4800
Mailing Address - Country:US
Mailing Address - Phone:305-669-0184
Mailing Address - Fax:
Practice Address - Street 1:7300 SW 62ND PL STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4800
Practice Address - Country:US
Practice Address - Phone:305-669-0184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty