Healthcare Provider Details

I. General information

NPI: 1023082112
Provider Name (Legal Business Name): DAVID RASKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8395 WEST OAKLAND PARK BLVD SUITE A
SUNRISE FL
33351
US

IV. Provider business mailing address

8395 WEST OAKLAND PARK BLVD SUITE A
SUNRISE FL
33351
US

V. Phone/Fax

Practice location:
  • Phone: 954-747-6220
  • Fax: 954-747-6755
Mailing address:
  • Phone: 954-747-6220
  • Fax: 954-747-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME43217
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: