Basic Information
| Provider Information | |||||||||
| NPI: | 1710223805 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MELVYN G DRUCKER MDPA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19955 PORTO VITA WAY | ||||||||
| Address2: | APT. 2701 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331803427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059327738 | ||||||||
| FaxNumber: | 3059329285 | ||||||||
| Practice Location | |||||||||
| Address1: | 20601 E DIXIE HWY | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7869233000 | ||||||||
| FaxNumber: | 7869233002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2012 | ||||||||
| LastUpdateDate: | 12/18/2012 | ||||||||
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| AuthorizedOfficialLastName: | DRUCKER | ||||||||
| AuthorizedOfficialFirstName: | MELVYN | ||||||||
| AuthorizedOfficialMiddleName: | GARY | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7869233000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2500X | ME12262 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
No ID Information.