Provider Demographics
NPI:1326144825
Name:PLAXE, JANICE S (DO)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:S
Last Name:PLAXE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3848 FAU BLVD #210
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431
Mailing Address - Country:US
Mailing Address - Phone:561-394-3088
Mailing Address - Fax:561-394-3077
Practice Address - Street 1:3848 FAU BLVD #210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-394-3088
Practice Address - Fax:561-394-3077
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10325207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001766600Medicaid
FLCB637ZMedicare PIN
FL001766600Medicaid