Healthcare Provider Details

I. General information

NPI: 1245421692
Provider Name (Legal Business Name): DAVID MIZRACHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE PALM BEACH RADIOLOGY PROFESSIONALS
ATLANTIS FL
33462-1149
US

IV. Provider business mailing address

5301 S CONGRESS AVE AVEPALM BEACH RADIOLOGY PROFESSIONALS
ATLANTIS FL
33462-1149
US

V. Phone/Fax

Practice location:
  • Phone: 561-548-1230
  • Fax: 561-548-1283
Mailing address:
  • Phone: 561-548-1230
  • Fax: 561-548-1283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD428446
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME98417
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: