Provider Demographics
NPI:1376377010
Name:SAMUEL GANZ MD PLLC
Entity type:Organization
Organization Name:SAMUEL GANZ MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GANZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-374-3981
Mailing Address - Street 1:10796 LAKE WYNDS CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3237
Mailing Address - Country:US
Mailing Address - Phone:917-374-3981
Mailing Address - Fax:
Practice Address - Street 1:10796 LAKE WYNDS CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3237
Practice Address - Country:US
Practice Address - Phone:917-374-3981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty