Provider Demographics
NPI:1265774574
Name:MARKWART, NATHAN MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:MICHAEL
Last Name:MARKWART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 POINCIANA PL
Mailing Address - Street 2:APT 403
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4848
Mailing Address - Country:US
Mailing Address - Phone:716-560-3616
Mailing Address - Fax:
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-939-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 13310207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine