Provider Demographics
NPI:1437458049
Name:DR GARY D ENKER PA
Entity Type:Organization
Organization Name:DR GARY D ENKER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-491-7141
Mailing Address - Street 1:6215 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1903
Mailing Address - Country:US
Mailing Address - Phone:954-491-7141
Mailing Address - Fax:954-491-7164
Practice Address - Street 1:6215 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1903
Practice Address - Country:US
Practice Address - Phone:954-491-7141
Practice Address - Fax:954-491-7164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty