Provider Demographics
NPI:1780173708
Name:EBNER, BERTRAND FABIEN (MD)
Entity type:Individual
Prefix:MR
First Name:BERTRAND
Middle Name:FABIEN
Last Name:EBNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7777 DAVIE ROAD EXT STE 100B
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2524
Mailing Address - Country:US
Mailing Address - Phone:543-623-4269
Mailing Address - Fax:
Practice Address - Street 1:7777 DAVIE ROAD EXT STE 100B
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2524
Practice Address - Country:US
Practice Address - Phone:543-623-4269
Practice Address - Fax:954-362-3432
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME171558207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology