Individual
MARTIN EBENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15901 BASS RD, SUITE 100, FORT MYERS, FL 33908
(239) 343-6100
(239) 343-9925
Mailing address
PO BOX 2147, FT MYERS, FL 33902-2147
(239) 343-6100
(239) 343-9925
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME0065358
FL
207VG0400X
Gynecology Physician
Primary
ME006358
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376275100
—
FL
Enumeration date
09/29/2005
Last updated
03/30/2023
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