MEDICARE: DR. STEVEN HART MISHKIND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	115184	MT
2	207P00000X	Emergency Medicine Physician	12927389-1205	UT
3	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	ME70920	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	31321	OTHER		BLUE CROSS

General Provider Information

NPI Number	:	1255417192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN HART MISHKIND M.D.

Provider Business Mailing Address
First Line	:	PO BOX 511196
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33951-1196
Country	:	US
Telephone Number	:	941-637-1505
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 N ROBERTS AVE
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34266-8765
Country	:	US
Telephone Number	:	863-494-3535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	10/03/2022

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