Organization
DAVID PORUDOMINSKY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PORUDOMINSKY MD (MD)
(786) 621-3897
Entity
Organization
Contact information
Practice address
2825 N STATE ROAD 7, SUITE 300, MARGATE, FL 33063-5737
(786) 621-3897
(786) 975-2643
Mailing address
2825 N STATE ROAD 7, SUITE 300, MARGATE, FL 33063-5737
(786) 621-3897
(786) 975-2643
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34983
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/31/2008
Last updated
05/16/2008
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