Provider Demographics
NPI:1104868744
Name:LUSKIN, BRANDON J (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:J
Last Name:LUSKIN
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 1:2828 S SEACREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7944
Mailing Address - Country:US
Mailing Address - Phone:561-395-2117
Mailing Address - Fax:561-395-4551
Practice Address - Street 1:2828 S SEACREST BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7944
Practice Address - Country:US
Practice Address - Phone:561-395-2117
Practice Address - Fax:561-395-4551
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073343207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG40818Medicare UPIN
FL41376Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID#