Provider Demographics
NPI:1730295676
Name:DRUCKER, DEBRA M (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:M
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 SHERIDAN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3409
Mailing Address - Country:US
Mailing Address - Phone:954-989-3600
Mailing Address - Fax:954-894-1884
Practice Address - Street 1:4600 SHERIDAN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3409
Practice Address - Country:US
Practice Address - Phone:954-989-3600
Practice Address - Fax:954-894-1884
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00595382084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE54370Medicare UPIN
FLAA263Medicare PIN