Healthcare Provider Details

I. General information

NPI: 1508868027
Provider Name (Legal Business Name): DAVID DREXLER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date: 03/22/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

12773 FOREST HILL BLVD SUITE 1203
WELLINGTON FL
33414-4767
US

IV. Provider business mailing address

12773 FOREST HILL BLVD SUITE 1203
WELLINGTON FL
33414-4767
US

V. Phone/Fax

Practice location:
  • Phone: 561-758-2271
  • Fax: 561-828-6225
Mailing address:
  • Phone: 561-758-2271
  • Fax: 561-828-6225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS11667
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: