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General NPI Number Information
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NPI Number | 1043259666
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Entity Type | Individual
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Provider Name | MITCHELL KOLKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 210 JUPITER LAKES BLVD STE 103
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City | JUPITER
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State | FL
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Zip | 33458-7187
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Country | US
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Telephone | 561-848-5579
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Fax |
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Provider Business Mailing Address
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Address Line | 8980 BIDDLE CT
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City | WELLINGTON
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State | FL
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Zip | 33414-6436
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Country | US
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Telephone | 914-837-5088
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME164698
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 231752
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License Number State | NY
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