Provider Demographics
NPI:1750573473
Name:M. GARY SCHORR MD PA
Entity type:Organization
Organization Name:M. GARY SCHORR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SCHORR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-364-2626
Mailing Address - Street 1:715 W BOYNTON BEACH BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3625
Mailing Address - Country:US
Mailing Address - Phone:561-737-8376
Mailing Address - Fax:561-734-7925
Practice Address - Street 1:715 W BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3625
Practice Address - Country:US
Practice Address - Phone:561-737-8376
Practice Address - Fax:561-734-7925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2974Medicare PIN