Provider Demographics
NPI:1386640852
Name:ESKENAZI, MARK STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:ESKENAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 LINTON BLVD
Mailing Address - Street 2:103
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6542
Mailing Address - Country:US
Mailing Address - Phone:561-381-4271
Mailing Address - Fax:561-381-4273
Practice Address - Street 1:5210 LINTON BLVD
Practice Address - Street 2:103
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6542
Practice Address - Country:US
Practice Address - Phone:561-381-4271
Practice Address - Fax:561-381-4273
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-10-17
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
FLME81621207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H27735Medicare UPIN
FL51925XMedicare ID - Type Unspecified
FLK6000Medicare ID - Type UnspecifiedPA GROUP