Provider Demographics
NPI:1508868027
Name:DREXLER, DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:DREXLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12773 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 1203
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4767
Mailing Address - Country:US
Mailing Address - Phone:561-758-2271
Mailing Address - Fax:561-828-6225
Practice Address - Street 1:12773 FOREST HILL BLVD
Practice Address - Street 2:SUITE 1203
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4767
Practice Address - Country:US
Practice Address - Phone:561-758-2271
Practice Address - Fax:561-828-6225
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2015-06-11
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
FLOS11667207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH47231Medicare UPIN