Healthcare Provider Details

I. General information

NPI: 1316943202
Provider Name (Legal Business Name): NEIL PIWOVAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NEIL PIWOVAR M.D.

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 N FLAGLER DR
WEST PALM BEACH FL
33401-3406
US

IV. Provider business mailing address

248 CANTERBURY CIR
PALM BEACH GARDENS FL
33418-8219
US

V. Phone/Fax

Practice location:
  • Phone: 561-650-6309
  • Fax:
Mailing address:
  • Phone: 561-622-8009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME57918
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: