Healthcare Provider Details

I. General information

NPI: 1134548019
Provider Name (Legal Business Name): ALEXANDER DAVID GAUKHMAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 GLADES RD STE 300
BOCA RATON FL
33431-6464
US

IV. Provider business mailing address

670 GLADES RD STE 300
BOCA RATON FL
33431-6464
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number145413
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: