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Individual

DMITRIY REZNIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
101 NE 3RD AVE STE 1500, FORT LAUDERDALE, FL 33301-1181
(954) 247-8790
(877) 594-6196
Mailing address
3031 TELEGRAPH AVE, OAKLAND, CA 94609-3205
(510) 596-8125
(510) 225-2745

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
019136
NY
363A00000X
Physician Assistant
085.002843
IL
363A00000X
Physician Assistant
57357
CA
363A00000X
Physician Assistant
Primary
PA9117176
FL

Other

Enumeration date
10/25/2006
Last updated
07/11/2023
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