Provider Demographics
NPI:1386702876
Name:MOSKOWITZ, BRUCE W (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:W
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRUCE
Other - Middle Name:W
Other - Last Name:MOSKOWITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PL
Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE 7100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3418
Mailing Address - Country:US
Mailing Address - Phone:561-833-6116
Mailing Address - Fax:561-833-6351
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 7100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3418
Practice Address - Country:US
Practice Address - Phone:561-833-6116
Practice Address - Fax:561-833-6351
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0027041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79028AOtherMEDICARE ID
FL79028AOtherMEDICARE ID