Provider Demographics
NPI:1710245840
Name:LENKA ZACHAR MD PLC
Entity Type:Organization
Organization Name:LENKA ZACHAR MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LENKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-308-5266
Mailing Address - Street 1:1650 MARGARET ST
Mailing Address - Street 2:SUITE 302 BOX 148
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3868
Mailing Address - Country:US
Mailing Address - Phone:904-308-5266
Mailing Address - Fax:904-308-5267
Practice Address - Street 1:3 SHIRCLIFF WAY STE 500
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4757
Practice Address - Country:US
Practice Address - Phone:904-308-5266
Practice Address - Fax:904-308-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68497208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250256900Medicaid
FL31925OtherBCBS