Provider Demographics
NPI:1710921143
Name:MOSTEL, EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:MOSTEL
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 1:3365 BURNS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4326
Mailing Address - Country:US
Mailing Address - Phone:561-775-1061
Mailing Address - Fax:561-775-1064
Practice Address - Street 1:3365 BURNS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4326
Practice Address - Country:US
Practice Address - Phone:561-775-1061
Practice Address - Fax:561-775-1064
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53241207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375816800Medicaid
FL375816800Medicaid
FLD61294Medicare UPIN