Provider Demographics
NPI:1861681694
Name:SHLOMO PASCAL MD PA
Entity Type:Organization
Organization Name:SHLOMO PASCAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-436-0136
Mailing Address - Street 1:1711 NW 123 AVENUE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3824
Mailing Address - Country:US
Mailing Address - Phone:954-436-0136
Mailing Address - Fax:954-447-9245
Practice Address - Street 1:1711 NW 123 AVENUE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3824
Practice Address - Country:US
Practice Address - Phone:954-436-0136
Practice Address - Fax:954-447-9245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH07495Medicare UPIN
FLAH693Medicare PIN