Provider Demographics
NPI:1285654434
Name:ALTSCHULER, MARK AARON (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:AARON
Last Name:ALTSCHULER
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 1:19930 NE 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1807
Mailing Address - Country:US
Mailing Address - Phone:305-931-9070
Mailing Address - Fax:
Practice Address - Street 1:19930 NE 23RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1807
Practice Address - Country:US
Practice Address - Phone:305-931-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME323632086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03667220Medicaid
FL03667220Medicaid
FL92992Medicare ID - Type Unspecified