Provider Demographics
NPI:1710115019
Name:RASKIN, MICHAEL MESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MESTER
Last Name:RASKIN
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 1:7710 NW 71ST CT
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2973
Mailing Address - Country:US
Mailing Address - Phone:954-726-0333
Mailing Address - Fax:954-726-2859
Practice Address - Street 1:7710 NW 71ST CT
Practice Address - Street 2:SUITE 207
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2973
Practice Address - Country:US
Practice Address - Phone:954-726-0333
Practice Address - Fax:954-726-2859
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC341592085R0202X
FL00163882085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058155100Medicaid
FLD66002Medicare UPIN
FL058155100Medicaid