Provider Demographics
NPI:1497816169
Name:DELANGE, GREGORY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:DELANGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:244 W RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-2948
Mailing Address - Country:US
Mailing Address - Phone:561-746-4466
Mailing Address - Fax:561-776-8495
Practice Address - Street 1:2865 PGA BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2910
Practice Address - Country:US
Practice Address - Phone:561-776-9555
Practice Address - Fax:561-776-8495
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 72823208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG64495Medicare UPIN