Provider Demographics
NPI:1316988173
Name:NORENBERG, ERIC J (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:NORENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:228 PONTE VEDRA PARK DR STE 500
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-6611
Practice Address - Country:US
Practice Address - Phone:904-273-1180
Practice Address - Fax:904-273-6116
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME56786207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09828OtherBCBS
FLKH840OtherMEDICARE