Provider Demographics
NPI:1255444071
Name:PLATT, JEFFREY H (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:H
Last Name:PLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14671 N BECKLEY SQ
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3069
Mailing Address - Country:US
Mailing Address - Phone:954-684-8999
Mailing Address - Fax:954-472-6322
Practice Address - Street 1:14671 N BECKLEY SQ
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-3069
Practice Address - Country:US
Practice Address - Phone:954-684-8999
Practice Address - Fax:954-472-6322
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81713208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260576700Medicaid
FLH66845Medicare UPIN
FL58012VMedicare ID - Type Unspecified
FL58012XMedicare ID - Type Unspecified