Individual
ELIZABETH KENTRA-GOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 E SAMPLE RD, DEERFIELD BEACH, FL 33064-3502
(954) 941-8300
Mailing address
717 EDGEMONT LN, PARK RIDGE, IL 60068-2652
(404) 218-2302
(904) 697-5890
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
035919
GA
207Y00000X
Otolaryngology Physician
ME130251
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000531539C
—
GA
05
—
023043400
—
FL
01
—
613724
BLUE CROSS BLUE SHIELD
GA
Enumeration date
06/10/2006
Last updated
05/14/2024
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