Healthcare Provider Details

I. General information

NPI: 1891374237
Provider Name (Legal Business Name): ALEKSANDER DRUCK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PLATINUM PT
LAKE MARY FL
32746-4871
US

IV. Provider business mailing address

701 PLATINUM PT
LAKE MARY FL
32746-4871
US

V. Phone/Fax

Practice location:
  • Phone: 473-332-7700
  • Fax: 407-332-9749
Mailing address:
  • Phone: 473-332-7700
  • Fax: 407-332-9749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME181343
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: