Healthcare Provider Details

I. General information

NPI: 1689838559
Provider Name (Legal Business Name): DAVID M PLANK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7652 ASHLEY PARK CT STE 305
ORLANDO FL
32835
US

IV. Provider business mailing address

7652 ASHLEY PARK CT STE 305
ORLANDO FL
32835-6199
US

V. Phone/Fax

Practice location:
  • Phone: 407-299-7333
  • Fax: 407-293-2049
Mailing address:
  • Phone: 407-299-7333
  • Fax: 407-293-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberC170508
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME105111
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: