Organization
ALEXANDER PUSHKA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER PUSHKA MD (OWNER)
(954) 579-1110
Entity
Organization
Contact information
Practice address
7369 SHERIDAN ST STE 203, HOLLYWOOD, FL 33024-2776
(954) 983-5330
(954) 983-5086
Mailing address
7369 SHERIDAN ST STE 203, HOLLYWOOD, FL 33024-2776
(954) 983-5330
(954) 983-5086
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
ME88666
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME88666
FL
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004704500
GROUP MEDICAID NUMBER
FL
Enumeration date
03/15/2012
Last updated
08/12/2020
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