Healthcare Provider Details

I. General information

NPI: 1114985850
Provider Name (Legal Business Name): DONALD KEUSCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5352 LINTON BLVD
DELRAY BEACH FL
33484-6514
US

IV. Provider business mailing address

781 NE 37TH ST
BOCA RATON FL
33431-6142
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-3145
  • Fax: 561-495-3240
Mailing address:
  • Phone: 561-362-8329
  • Fax: 561-362-8329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number53925
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: