Provider Demographics
NPI:1124148432
Name:PETER F MERKLE MD PA
Entity type:Organization
Organization Name:PETER F MERKLE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MERKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-783-7100
Mailing Address - Street 1:1101 E SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5113
Mailing Address - Country:US
Mailing Address - Phone:954-783-7100
Mailing Address - Fax:954-783-7304
Practice Address - Street 1:1101 E SAMPLE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5104
Practice Address - Country:US
Practice Address - Phone:954-783-7100
Practice Address - Fax:954-783-7304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51275213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05996OtherBLUE SHIELD PROVIDER #
FL05996OtherBLUE SHIELD PROVIDER #
FL0527990001Medicare NSC
FLK3690Medicare PIN