Provider Demographics
NPI:1689699654
Name:SKOLNICK, CRAIG A (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:SKOLNICK
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 1:641 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-296-2010
Mailing Address - Fax:561-296-2001
Practice Address - Street 1:641 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-296-2010
Practice Address - Fax:561-296-2001
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82429207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
01688XMedicare PIN
FLH41293Medicare UPIN