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General NPI Number Information
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NPI Number | 1417017666
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Entity Type | Organization
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Legal Business Name | MARGATE MEDICAL ASSOCIATES PA
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2825 N STATE ROAD 7
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City | MARGATE
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State | FL
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Zip | 33063-5737
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Country | US
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Telephone | 954-977-4101
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Fax | 954-977-6650
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Provider Business Mailing Address
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Address Line | 2825 N STATE ROAD 7
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City | MARGATE
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State | FL
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Zip | 33063-5737
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Country | US
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Telephone | 954-977-4101
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Fax | 954-977-6650
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JACK A KRAVITZ
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Credential | M.D
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Telephone | 954-977-4101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number | 0041286
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License Number State | FL
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