Provider Demographics
NPI:1760911796
Name:DR DAN PLASTIC SURGERY
Entity Type:Organization
Organization Name:DR DAN PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-681-3401
Mailing Address - Street 1:PO BOX 4651
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33338-4651
Mailing Address - Country:US
Mailing Address - Phone:954-991-8200
Mailing Address - Fax:
Practice Address - Street 1:2122 NW 62ND ST STE 229
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1858
Practice Address - Country:US
Practice Address - Phone:954-991-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-04
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty