Provider Demographics
NPI:1770586299
Name:MEYEROWITZ, TREVOR (PT)
Entity type:Individual
Prefix:MR
First Name:TREVOR
Middle Name:
Last Name:MEYEROWITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7246 CARMEL CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7246 CARMEL CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5544
Practice Address - Country:US
Practice Address - Phone:561-542-0060
Practice Address - Fax:561-395-6995
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-30
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19785171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7737Medicare ID - Type UnspecifiedMEDICARE PROVIDER #