# FREDERICK FERGUSON MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710161815
- **Authorized official:** DR. FREDERICK FERGUSON M.D. (PRESIDENT)
- **Authorized official phone:** (305) 655-1025

## Contact information

- **Practice address:** 100 NW 170TH ST, 301, NORTH MIAMI BEACH, FL 33169-5513
- **Practice address phone:** (305) 655-1025
- **Practice address fax:** (305) 652-9530
- **Mailing address:** 100 NW 170TH ST, 301, NORTH MIAMI BEACH, FL 33169-5513
- **Mailing address phone:** (305) 655-1025
- **Mailing address fax:** (305) 652-9530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME75338 | FL | Yes |

## Other

- **Enumeration date:** 12/26/2007
- **Last updated:** 12/26/2007