Provider Demographics
NPI:1295409688
Name:MICHAEL P. ZAHALSKY, MD PA
Entity Type:Organization
Organization Name:MICHAEL P. ZAHALSKY, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT RECEIVABLE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LEA
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLETIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-714-8200
Mailing Address - Street 1:5850 CORAL RIDGE DR STE 106
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3379
Mailing Address - Country:US
Mailing Address - Phone:954-714-8200
Mailing Address - Fax:
Practice Address - Street 1:2951 NW 49TH AVE STE 308
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-1617
Practice Address - Country:US
Practice Address - Phone:954-714-8200
Practice Address - Fax:954-840-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001667401Medicaid