MEDICARE: DR. NEIL NATKOW DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	OS4423	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	80014	OTHER	FL	MEDICARE PARTICIPATING OR SUPPLIER AGREEMENT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275989378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL NATKOW DO

Provider Business Mailing Address
First Line	:	2447 EAGLE RUN WAY
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-1432
Country	:	US
Telephone Number	:	954-646-6761
Fax Number	:	954-389-2681

Provider Business Practice Location Address
First Line	:	2447 EAGLE RUN WAY
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-1432
Country	:	US
Telephone Number	:	954-646-6761
Fax Number	:	954-389-2681

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	05/06/2016

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Directions to “ DR. NEIL NATKOW DO” Practice Location

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