Provider Demographics
NPI:1235177882
Name:DWECK, MAX K (MD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:K
Last Name:DWECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:603 N FLAMINGO RD
Mailing Address - Street 2:SUITE 358
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1023
Mailing Address - Country:US
Mailing Address - Phone:954-438-9800
Mailing Address - Fax:954-438-7544
Practice Address - Street 1:603 N FLAMINGO RD
Practice Address - Street 2:SUITE 358
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1023
Practice Address - Country:US
Practice Address - Phone:954-438-9800
Practice Address - Fax:954-438-7544
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 42300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
96789TOtherMEDICARE PTAN
FL064612100Medicaid
96789TOtherMEDICARE PTAN
FL064612100Medicaid