Provider Demographics
NPI:1760541130
Name:EBERLE, NATHAN ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ANDREW
Last Name:EBERLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:17160 ROYAL PALM BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-507-4540
Mailing Address - Fax:954-507-4539
Practice Address - Street 1:17160 ROYAL PALM BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326
Practice Address - Country:US
Practice Address - Phone:954-507-4540
Practice Address - Fax:954-507-4539
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2017-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLDN177771223S0112X
FLME114687208600000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery