Provider Demographics
NPI:1750533865
Name:MELVIN A. MACKLER, M.D. PA.
Entity type:Organization
Organization Name:MELVIN A. MACKLER, M.D. PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACKLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-270-6000
Mailing Address - Street 1:7400 S.W. 87 AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-270-6000
Mailing Address - Fax:305-598-7754
Practice Address - Street 1:151 N.W. 11 STREET
Practice Address - Street 2:SUITE 202B
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030
Practice Address - Country:US
Practice Address - Phone:305-245-1002
Practice Address - Fax:305-245-7599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME15250208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD59556Medicare UPIN