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General NPI Number Information
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NPI Number | 1578502399
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Entity Type | Individual
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Provider Name | MICHAEL A RAVITSKY DO
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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 | 03/07/2023
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Provider Practice Location Address
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Address Line | 4700 N CONGRESS AVE STE 103
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City | WEST PALM BEACH
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State | FL
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Zip | 33407
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Country | US
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Telephone | 561-255-3131
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Fax | 855-346-3451
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Provider Business Mailing Address
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Address Line | 1094 MILITARY TRL
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City | JUPITER
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State | FL
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Zip | 33458-7021
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Country | US
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Telephone | 561-255-3131
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Fax | 855-215-9930
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS0003855
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License Number State | FL
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