Healthcare Provider Details

I. General information

NPI: 1922004324
Provider Name (Legal Business Name): ISTVAN KRISKO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11040 TURTLE BEACH RD
NORTH PALM BEACH FL
33408-3415
US

IV. Provider business mailing address

11040 TURTLE BEACH RD
NORTH PALM BEACH FL
33408-3415
US

V. Phone/Fax

Practice location:
  • Phone: 561-622-2397
  • Fax: 561-626-6351
Mailing address:
  • Phone: 561-622-2397
  • Fax: 561-626-6351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME28092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: