Organization Active NPI

David Mishkin D.O. P.a.

  • Family Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1346412970
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS8314 Issued in FL
Legal business name
DAVID MISHKIN D.O. P.A.
Practice address
2021 E Commercial Blvd
Suite 301
Fort Lauderdale, FL 33308
Phone
(954) 202-7899
Fax
(954) 202-7877
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. David B Mishkin, D.O.NPI 1700896206
Title
Owner/President
Phone
(954) 202-7899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS8314 FL Primary

Addresses

Primary practice location

2021 E Commercial Blvd
Suite 301
Fort Lauderdale, FL 33308

Mailing address

2021 E Commercial Blvd
Suite 301
Fort Lauderdale, FL 33308
Phone (954) 202-7899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000428 FL Part B Supplier - Clinic/Group Practice 7517950330 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

550 SW 3rd St
Ste 101B
Pompano Beach, FL 33060
Phone (954) 202-7899

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1346412970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-202-7899",
            "fax_number": "954-202-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-202-7899",
            "fax_number": "954-202-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID MISHKIN D.O. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "MISHKIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-202-7899",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.