MEDICARE: ALEXANDER PUSHKA MD

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	2084P0800X	Psychiatry Physician	2023-02477	NC
2	2084P0800X	Psychiatry Physician	ME88666	FL
3	2084P0804X	Child & Adolescent Psychiatry Physician	2023-02477	NC
4	2084P0804X	Child & Adolescent Psychiatry Physician	ME88666	FL

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	:	1992793384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER PUSHKA MD

Provider Business Mailing Address
First Line	:	7369 SHERIDAN ST STE 203
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2776
Country	:	US
Telephone Number	:	954-983-5330
Fax Number	:	954-983-5086

Provider Business Practice Location Address
First Line	:	7369 SHERIDAN ST STE 203
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2776
Country	:	US
Telephone Number	:	954-983-5330
Fax Number	:	954-983-5086

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	08/20/2025

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Directions to “ ALEXANDER PUSHKA MD” Practice Location

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