Provider Demographics
NPI:1780773465
Name:FALCHOOK, ADAM D (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:FALCHOOK
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 1:1111 SE INDIAN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5765
Mailing Address - Country:US
Mailing Address - Phone:772-675-0000
Mailing Address - Fax:772-675-1111
Practice Address - Street 1:1111 SE INDIAN ST STE 102
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5765
Practice Address - Country:US
Practice Address - Phone:772-675-0000
Practice Address - Fax:772-675-1111
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN10013207R00000X
FLME1067272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003745600Medicaid
FL003745600Medicaid