Provider Demographics
NPI:1982964870
Name:ERGLE, KEVIN DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:DENNIS
Last Name:ERGLE
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 1:8251 W BROWARD BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2703
Mailing Address - Country:US
Mailing Address - Phone:954-731-1101
Mailing Address - Fax:954-731-5637
Practice Address - Street 1:8251 W BROWARD BLVD STE 304
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2703
Practice Address - Country:US
Practice Address - Phone:954-731-1101
Practice Address - Fax:954-731-5637
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01080409A207R00000X, 207RC0000X
FLTRN17548207R00000X
FLME141430207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease