Provider Demographics
NPI:1245421692
Name:MIZRACHI, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MIZRACHI
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:5301 S CONGRESS AVE
Mailing Address - Street 2:AVEPALM BEACH RADIOLOGY PROFESSIONALS
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1149
Mailing Address - Country:US
Mailing Address - Phone:561-548-1230
Mailing Address - Fax:561-548-1283
Practice Address - Street 1:5301 S CONGRESS AVE
Practice Address - Street 2:PALM BEACH RADIOLOGY PROFESSIONALS
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1149
Practice Address - Country:US
Practice Address - Phone:561-548-1230
Practice Address - Fax:561-548-1283
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-10-18
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Provider Licenses
StateLicense IDTaxonomies
PAMD4284462085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology