Provider Demographics
NPI:1407991839
Name:MISHKEL, DAVID CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:MISHKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 GLADES RD
Mailing Address - Street 2:EAST TOWER SUITE 200
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7386
Mailing Address - Country:US
Mailing Address - Phone:561-338-8884
Mailing Address - Fax:561-338-5230
Practice Address - Street 1:2300 GLADES RD
Practice Address - Street 2:EAST TOWER SUITE 200
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7386
Practice Address - Country:US
Practice Address - Phone:561-338-8884
Practice Address - Fax:561-338-5230
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 66416207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375708100Medicaid
FL25686YMedicare ID - Type Unspecified