Basic Information
| Provider Information | |||||||||
| NPI: | 1710947171 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASHKIN | ||||||||
| FirstName: | DAVID | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 266211 | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333266211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619674118 | ||||||||
| FaxNumber: | 5615403788 | ||||||||
| Practice Location | |||||||||
| Address1: | 5401 S CONGRESS AVE | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334626635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619674118 | ||||||||
| FaxNumber: | 5615403788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 05/21/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME57191 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | ME57191 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | ME57191 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 064399800 | 05 | FL | MEDICAID |