Provider Demographics
NPI:1609982669
Name:MISKOLCZI, LASZLO (MD)
Entity Type:Individual
Prefix:
First Name:LASZLO
Middle Name:
Last Name:MISKOLCZI
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 1:4725 NORTH FEDERAL HIGHWAY
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-492-5780
Mailing Address - Fax:954-492-5773
Practice Address - Street 1:4725 NORTH FEDERAL HIGHWAY
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-492-5780
Practice Address - Fax:954-492-5773
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL945672085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274138500Medicaid
FL30759ZMedicare ID - Type Unspecified