Provider Demographics
NPI:1982885331
Name:PHILIP F AVERBUCH MD PA
Entity Type:Organization
Organization Name:PHILIP F AVERBUCH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:AVERBUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-722-0040
Mailing Address - Street 1:9750 NW 33RD ST STE 116
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4000
Mailing Address - Country:US
Mailing Address - Phone:954-722-0040
Mailing Address - Fax:954-344-7964
Practice Address - Street 1:9750 NW 33RD ST STE 116
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-722-0040
Practice Address - Fax:954-344-7964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAI325Medicare PIN
FL0193490001Medicare NSC
D65790Medicare UPIN