Provider Demographics
NPI:1134107915
Name:PRESTE, PAUL GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GEORGE
Last Name:PRESTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3075 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4311
Mailing Address - Country:US
Mailing Address - Phone:954-491-6200
Mailing Address - Fax:704-658-0553
Practice Address - Street 1:3075 E COMMERCIAL BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4318
Practice Address - Country:US
Practice Address - Phone:954-491-6200
Practice Address - Fax:877-251-3308
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038476174400000X
FLME38476207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist