Provider Demographics
NPI:1467485946
Name:SZOKE, ERVIN (MD)
Entity Type:Individual
Prefix:
First Name:ERVIN
Middle Name:
Last Name:SZOKE
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 1:2290 W EAU GALLIE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3133
Mailing Address - Country:US
Mailing Address - Phone:321-309-9000
Mailing Address - Fax:321-309-9002
Practice Address - Street 1:2290 W EAU GALLIE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3133
Practice Address - Country:US
Practice Address - Phone:321-309-9000
Practice Address - Fax:321-309-9002
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50329207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1467485946Medicaid
WI002146210Medicare PIN
WI1467485946Medicaid