Healthcare Provider Details

I. General information

NPI: 1003892100
Provider Name (Legal Business Name): RONALD FLASTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 N STATE ROAD 7
MARGATE FL
33063-5727
US

IV. Provider business mailing address

1613 NW 136TH AVE BUILDING C, SUITE #200
SUNRISE FL
33323-2853
US

V. Phone/Fax

Practice location:
  • Phone: 954-974-0400
  • Fax:
Mailing address:
  • Phone: 954-838-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME68229
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: