Provider Demographics
NPI:1942385919
Name:BLOCK, MICHAEL E (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:BLOCK
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:5162 LINTON BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6567
Mailing Address - Country:US
Mailing Address - Phone:561-499-8686
Mailing Address - Fax:561-499-1879
Practice Address - Street 1:5162 LINTON BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6567
Practice Address - Country:US
Practice Address - Phone:561-499-8686
Practice Address - Fax:561-499-1879
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2013-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS7605207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG81859Medicare UPIN
FLK7756Medicare PIN