Provider Demographics
NPI:1053374017
Name:GORENSEK, MARGARET J (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:GORENSEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:936 INTRACOSTAL DR #19B
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304
Mailing Address - Country:US
Mailing Address - Phone:954-568-2618
Mailing Address - Fax:954-493-9472
Practice Address - Street 1:2151 E COMMERCIAL BLVD, STE 203
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-489-2260
Practice Address - Fax:954-489-2261
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0052072207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049376700Medicaid
FLD61157Medicare UPIN
FL04865ZMedicare ID - Type Unspecified