Individual
BLAIR ANDREW FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1120 BAYVIEW DR, FORT LAUDERDALE, FL 33304-2505
(954) 537-4106
Mailing address
1120 BAYVIEW DR, FORT LAUDERDALE, FL 33304-2505
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
11003063
FL
363LF0000X
Family Nurse Practitioner
Primary
11003063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11003063
FLORIDA NURSING BOARD
FL
Enumeration date
07/02/2019
Last updated
07/02/2019
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