Provider Demographics
NPI:1881805026
Name:PLATT, RONALD IRA (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:IRA
Last Name:PLATT
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 1:7807 BOULDER LN
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2369
Mailing Address - Country:US
Mailing Address - Phone:954-575-2557
Mailing Address - Fax:954-575-2559
Practice Address - Street 1:7807 BOULDER LN
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-2369
Practice Address - Country:US
Practice Address - Phone:954-575-2557
Practice Address - Fax:954-575-2559
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02176200208000000X
FLME 81215208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC59196Medicare UPIN