MEDICARE: DR. DAVID IJAC MD

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	207R00000X	Internal Medicine Physician	ME0050568	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

General Provider Information

NPI Number	:	1649255951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID IJAC MD

Provider Business Mailing Address
First Line	:	10151 ENTERPRISE CENTER BLVD
Second Line	:	#101
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3759
Country	:	US
Telephone Number	:	561-732-2136
Fax Number	:	561-735-6501

Provider Business Practice Location Address
First Line	:	10151 ENTERPISE CENTER BLVD
Second Line	:	#101
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3724
Country	:	US
Telephone Number	:	561-732-2136
Fax Number	:	561-735-6501

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	01/18/2024

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Directions to “ DR. DAVID IJAC MD” Practice Location

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