Provider Demographics
NPI:1396073920
Name:GREGORY ALBERT M.D., P.A.
Entity type:Organization
Organization Name:GREGORY ALBERT M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:561-495-2700
Mailing Address - Street 1:6290 LINTON BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6409
Mailing Address - Country:US
Mailing Address - Phone:561-495-2700
Mailing Address - Fax:561-495-5826
Practice Address - Street 1:6290 LINTON BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6409
Practice Address - Country:US
Practice Address - Phone:561-495-2700
Practice Address - Fax:561-495-5826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79606174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH11795Medicare UPIN
FL49835Medicare PIN