Provider Demographics
NPI:1184365405
Name:PLEETER, EZRA (DO)
Entity type:Individual
Prefix:
First Name:EZRA
Middle Name:
Last Name:PLEETER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-341-0074
Mailing Address - Fax:
Practice Address - Street 1:9120A WILES RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-1993
Practice Address - Country:US
Practice Address - Phone:954-341-0074
Practice Address - Fax:954-345-3474
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS22130208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics