Basic Information
| Provider Information | |||||||||
| NPI: | 1073721726 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EBERSBERGER | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 NW 64TH ST | ||||||||
| Address2: | SUITE 700 | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333091800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545804084 | ||||||||
| FaxNumber: | 9545305096 | ||||||||
| Practice Location | |||||||||
| Address1: | 2964 N STATE ROAD 7 | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | MARGATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330635715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545804080 | ||||||||
| FaxNumber: | 9545804081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 01/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0801X | 01064933A | IN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma | 207XX0801X | ME121238 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
No ID Information.