| Institute Of Diabetes And Weight Management | |
|
1324 Se 17th St Fort Lauderdale FL 33316-1708 | |
| (754) 777-1333 | |
| Not Available |
| Full Name | Institute Of Diabetes And Weight Management |
|---|---|
| Speciality | Internal Medicine |
| Location | 1324 Se 17th St, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Alexander Birukoff (MANAGER) |
| Authorized Official Contact | 7547771333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Institute Of Diabetes And Weight Management 10862 Crescendo Cir Boca Raton FL 33498-4873 Ph: (912) 401-3883 | Institute Of Diabetes And Weight Management 1324 Se 17th St Fort Lauderdale FL 33316-1708 Ph: (754) 777-1333 |
| NPI Number | 1477303055 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 10/31/2024 |
| Medicare PECOS PAC ID | 4587003488 |
|---|---|
| Medicare Enrollment ID | O20240411001833 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477303055 | NPI | - | NPPES |
| 1477303055 | Medicaid | FL | |
| 1063775674 | Medicaid | FL | |
| 1295597664 | Medicaid | FL | |
| ST035 | Medicaid | FL | |
| ST058 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Alexander Birukoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295597664 PECOS PAC ID: 5496194391 Enrollment ID: I20240411002226 |
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