Provider Demographics
NPI:1861544207
Name:DWECK, MERRYL ELAINE (MD)
Entity type:Individual
Prefix:
First Name:MERRYL
Middle Name:ELAINE
Last Name:DWECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MERRYL
Other - Middle Name:ELAINE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2520 SANDS WAY
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7480 FAIRWAY DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:305-823-2222
Practice Address - Fax:305-823-4349
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43606208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics