Enrique Hanabergh Jr., M.D., P.a.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME 104210 Issued in FL

Legal business name

ENRIQUE HANABERGH JR., M.D., P.A.

Practice address

21097 NE 27TH CT
Suite 210
Aventura, FL 33180-1204

Phone

(305) 328-9557

Fax

(855) 760-7770

NPI assigned

Jul 29, 2011

Last updated

Jul 29, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Enrique Hanabergh Jr., M.D.NPI 1760617716

Title

President/Ceo

Phone

(305) 310-2799

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Enrique Hanabergh Jr., M.D.

  • Plastic Surgery Physician
  • Aventura, FL
  • NPI 1760617716
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1316225030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21097 NE 27TH CT",
            "address_2": "SUITE 210",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801204",
            "telephone_number": "305-328-9557",
            "fax_number": "855-760-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21097 NE 27TH CT",
            "address_2": "SUITE 210",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801204",
            "telephone_number": "305-328-9557",
            "fax_number": "855-760-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENRIQUE HANABERGH JR., M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "HANABERGH",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "305-310-2799",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME 104210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Aventura, FL
• Providers in Aventura, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.