Healthcare Provider Details

I. General information

NPI: 1659418614
Provider Name (Legal Business Name): STEVEN PLISKOW SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 VILLAGE BLVD SUITE 201
WEST PALM BEACH FL
33409
US

IV. Provider business mailing address

603 VILLAGE BLVD SUITE 201
WEST PALM BEACH FL
33409
US

V. Phone/Fax

Practice location:
  • Phone: 561-683-1331
  • Fax: 561-683-4615
Mailing address:
  • Phone: 561-683-1331
  • Fax: 561-683-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME0054211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: