Provider Demographics
NPI:1053482331
Name:GARBER, HARVEY IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:IVAN
Last Name:GARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 LINTON BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6611
Mailing Address - Country:US
Mailing Address - Phone:561-495-0660
Mailing Address - Fax:561-495-0677
Practice Address - Street 1:4675 LINTON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6611
Practice Address - Country:US
Practice Address - Phone:561-495-0660
Practice Address - Fax:561-495-0677
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40881208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD67343Medicare UPIN
FL79771ZMedicare ID - Type Unspecified