Individual
MR. GRAY MATTHEW FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12651 W SUNRISE BLVD, SUITE 202, SUNRISE, FL 33323-0906
(954) 838-7200
(954) 838-9192
Mailing address
8320 W SUNRISE BLVD, SUITE 208, PLANTATION, FL 33322-5435
(954) 838-7200
(954) 838-9192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS7890
FL
Other
Enumeration date
10/18/2006
Last updated
11/19/2008
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