Provider Demographics
NPI:1336107655
Name:ZOHAR MEDICAL CENTER
Entity Type:Organization
Organization Name:ZOHAR MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WOOLFSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:305-405-6644
Mailing Address - Street 1:16483 NE 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4052
Mailing Address - Country:US
Mailing Address - Phone:305-944-2372
Mailing Address - Fax:305-405-6622
Practice Address - Street 1:16600 NE 8TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3618
Practice Address - Country:US
Practice Address - Phone:305-405-6644
Practice Address - Fax:305-405-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4905261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8495Medicare ID - Type UnspecifiedPT/OT PART B CLINIC