Provider Demographics
NPI:1801864137
Name:ZAHALSKY, MICHAEL PRESTON (MD, PA)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PRESTON
Last Name:ZAHALSKY
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:P
Other - Last Name:ZAHALSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PA
Mailing Address - Street 1:5850 CORAL RIDGE DRIVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-1600
Mailing Address - Country:US
Mailing Address - Phone:954-714-8200
Mailing Address - Fax:954-840-2626
Practice Address - Street 1:5850 CORAL RIDGE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3378
Practice Address - Country:US
Practice Address - Phone:954-714-8200
Practice Address - Fax:954-840-2626
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-11
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93599174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20-2763393OtherTAX ID #
FL2729687000Medicaid
FLU5666ZMedicare ID - Type Unspecified
FL20-2763393OtherTAX ID #