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General NPI Number Information
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NPI Number | 1265774574
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Entity Type | Individual
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Provider Name | NATHAN MICHAEL MARKWART D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 1601 CLINT MOORE RD SUITE 100
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City | BOCA RATON
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State | FL
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Zip | 33487-2768
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Country | US
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Telephone | 561-939-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 9420 POINCIANA PL APT 403
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City | DAVIE
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State | FL
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Zip | 33324-4848
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Country | US
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Telephone | 716-560-3616
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | OS 13310
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License Number State | FL
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