Provider Demographics
NPI:1407805021
Name:ADAM S PLOTKIN MD PA
Entity Type:Organization
Organization Name:ADAM S PLOTKIN MD PA
Other - Org Name:PALM BEACH DERMATOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:PLOTKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-210-7555
Mailing Address - Street 1:5210 LINTON BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6542
Mailing Address - Country:US
Mailing Address - Phone:561-499-0660
Mailing Address - Fax:561-499-4094
Practice Address - Street 1:3654 SW 30TH AVE
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3700
Practice Address - Country:US
Practice Address - Phone:772-210-7555
Practice Address - Fax:772-266-8207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39263Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER