Provider Demographics
NPI:1265779490
Name:PLASKOFF, BART E (MED, MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:BART
Middle Name:E
Last Name:PLASKOFF
Suffix:
Gender:M
Credentials:MED, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 NW 171ST TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2110
Mailing Address - Country:US
Mailing Address - Phone:702-738-7554
Mailing Address - Fax:
Practice Address - Street 1:1144 NW 171ST TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2110
Practice Address - Country:US
Practice Address - Phone:702-738-7554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW164061041C0700X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty