Healthcare Provider Details

I. General information

NPI: 1114074853
Provider Name (Legal Business Name): PAUL G PRESTE MD & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 E COMMERCIAL BLVD STE 1A
FT LAUDERDALE FL
33308-4311
US

IV. Provider business mailing address

3075 E COMMERCIAL BLVD STE 1A
FT LAUDERDALE FL
33308-4311
US

V. Phone/Fax

Practice location:
  • Phone: 954-491-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number38476
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number16517
License Number StateFL

VIII. Authorized Official

Name: DR. PAUL G PRESTE
Title or Position: OWNER
Credential: M.D.
Phone: 954-491-6200