Provider Demographics
NPI:1073721726
Name:EBERSBERGER, MARC LEE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:LEE
Last Name:EBERSBERGER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1700 NW 64TH ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1800
Mailing Address - Country:US
Mailing Address - Phone:954-580-4084
Mailing Address - Fax:954-530-5096
Practice Address - Street 1:2964 N STATE ROAD 7
Practice Address - Street 2:SUITE 205
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5715
Practice Address - Country:US
Practice Address - Phone:954-580-4080
Practice Address - Fax:954-580-4081
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-01-27
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Provider Licenses
StateLicense IDTaxonomies
IN01064933A207XX0801X
FLME121238207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIB623ZMedicare PIN
VA1073721726Medicare PIN