Provider Demographics
NPI:1740281641
Name:TENZEL, DAVID P (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:TENZEL
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:PO BOX 39209
Mailing Address - Street 2:
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339
Mailing Address - Country:US
Mailing Address - Phone:954-851-9966
Mailing Address - Fax:954-318-7360
Practice Address - Street 1:8395 W. OAKLAND PK BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-776-2820
Practice Address - Fax:954-776-1442
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056327207W00000X
FLME56586207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE60443Medicare UPIN
FL09636ZMedicare ID - Type UnspecifiedMEDICARE
FL09636EMedicare PIN