Provider Demographics
NPI:1255370235
Name:HUSTED, DAVID S (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:HUSTED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:SHAKESPEARE
Other - Last Name:HUSTED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5503 S CONGRESS AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6625
Mailing Address - Country:US
Mailing Address - Phone:561-964-7511
Mailing Address - Fax:561-964-7544
Practice Address - Street 1:3365 BURNS RD STE 203
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4303
Practice Address - Country:US
Practice Address - Phone:561-402-3971
Practice Address - Fax:561-422-4799
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1177182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00471057OtherMEDICARE RAILROAD
NC147TPOtherBCBS
NC147TPOtherBCBS
2021771Medicare PIN