Provider Demographics
NPI:1891995890
Name:SLUCHAK, MAX (M D)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:SLUCHAK
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N. W. 70H AVE.
Mailing Address - Street 2:STE 2
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2911
Mailing Address - Country:US
Mailing Address - Phone:954-584-9534
Mailing Address - Fax:954-584-9684
Practice Address - Street 1:150 N. W. 70TH AVE.
Practice Address - Street 2:STE 2
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2911
Practice Address - Country:US
Practice Address - Phone:954-584-9534
Practice Address - Fax:954-584-9684
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12162ME207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12162MEOtherFLORIDA LICENSE