Provider Demographics
NPI:1649487661
Name:PANZER, GILBERT R (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:R
Last Name:PANZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 N OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN RIDGE
Mailing Address - State:FL
Mailing Address - Zip Code:33435-3315
Mailing Address - Country:US
Mailing Address - Phone:561-736-2051
Mailing Address - Fax:561-736-2948
Practice Address - Street 1:6810 N OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN RIDGE
Practice Address - State:FL
Practice Address - Zip Code:33435-3315
Practice Address - Country:US
Practice Address - Phone:561-736-2051
Practice Address - Fax:561-736-2948
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28567207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBP9195036OtherDEA NUMBER
FLBP9195036OtherDEA NUMBER
FL50900ZMedicare ID - Type Unspecified