Provider Demographics
NPI:1316133408
Name:MICHAEL E BLOCK DO PA
Entity type:Organization
Organization Name:MICHAEL E BLOCK DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-499-8686
Mailing Address - Street 1:5162 LINTON BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6567
Mailing Address - Country:US
Mailing Address - Phone:561-499-8686
Mailing Address - Fax:561-499-1879
Practice Address - Street 1:5162 LINTON BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6567
Practice Address - Country:US
Practice Address - Phone:561-499-8686
Practice Address - Fax:561-499-1879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7605207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7756Medicare PIN