Provider Demographics
NPI:1275889867
Name:MOSKOVITS, JONATHAN MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:MICHAEL
Last Name:MOSKOVITS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 W WOOLBRIGHT RD
Mailing Address - Street 2:SUITE 418
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-0917
Mailing Address - Country:US
Mailing Address - Phone:561-244-4980
Mailing Address - Fax:
Practice Address - Street 1:6609 W WOOLBRIGHT RD
Practice Address - Street 2:SUITE 418
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-0917
Practice Address - Country:US
Practice Address - Phone:561-244-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3566213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery