Individual
DR. KENNETH C. FORTGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1125 BEL AIR DR, HIGHLAND BEACH, FL 33487-4207
(561) 756-4610
(561) 274-6770
Mailing address
1125 BEL AIR DRIVE, HIGHLAND BEACH, FL 33487
(561) 756-4610
(561) 274-6770
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME43615
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068688300
—
FL
01
—
300033744
RAILROAD MEDICARE
FL
Enumeration date
12/06/2005
Last updated
06/03/2010
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