Provider Demographics
NPI:1912963844
Name:PASTON, PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:PASTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2889 10TH AVE N
Mailing Address - Street 2:STE 305
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461
Mailing Address - Country:US
Mailing Address - Phone:561-227-3117
Mailing Address - Fax:561-227-3183
Practice Address - Street 1:2889 10TH AVE N
Practice Address - Street 2:STE 305
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461
Practice Address - Country:US
Practice Address - Phone:561-227-3117
Practice Address - Fax:561-227-3183
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME9037207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D55648Medicare UPIN