Individual provider Active NPI

Garry Bruce Gewirtzman, MD

  • Dermatology Physician
  • Plantation, FL
National Provider Identifier
1932104502
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME26927 Issued in FL
Practice address
261 N. University Drive
S. 720
Plantation, FL 33324-1857
Phone
(954) 473-6750
Fax
(954) 424-7093
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME26927 FL Primary

Addresses

Primary practice location

261 N. University Drive
S. 720
Plantation, FL 33324-1857

Mailing address

261 N. University Drive
S. 720
Plantation, FL 33324-1857
Phone (954) 473-6750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26927FLMDDentist
ME26927FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin and Cancer Associates Dermatology CurrentSince Jun 15, 2021 Accepting new patients

Locations

201 NW 82nd Ave
Ste 501
Plantation, FL 33324
Phone (954) 473-6750

261 N University Dr
Ste 720
Plantation, FL 33324
Phone (954) 473-6750

1560 Sawgrass Corporate Pkwy
Ste 220
Sunrise, FL 33323

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1932104502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N. UNIVERSITY DRIVE",
            "address_2": "S. 720",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241857",
            "telephone_number": "954-473-6750",
            "fax_number": "954-424-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N. UNIVERSITY DRIVE",
            "address_2": "S. 720",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241857",
            "telephone_number": "954-473-6750",
            "fax_number": "954-424-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEWIRTZMAN",
        "first_name": "GARRY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME26927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.