Provider Demographics
NPI:1922068436
Name:PACHTER, ERIC M (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:PACHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:STE. 402
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1015
Mailing Address - Country:US
Mailing Address - Phone:954-704-3900
Mailing Address - Fax:954-701-1424
Practice Address - Street 1:2234 COLONIAL BLVD
Practice Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1412
Practice Address - Country:US
Practice Address - Phone:239-931-7342
Practice Address - Fax:239-931-7385
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76080208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7006030OtherAETNA
FLP01710335OtherSIMPLY HEALTHCARE
FL242805OtherAVMED
FLP00280681OtherRAILROAD MEDICARE
FL0181691OtherCIGNA
FL23162OtherMEDICA
FL43600OtherBLUE CROSS BLUE SHIELD
FLP01027499OtherRAILROAD MCR
FL029734OtherNHP
FL255098900Medicaid
FL2252476OtherAETNA
FLF00184753802OtherUNITED HEALTHCARE
FL1193424OtherWELLCARE
FL48795OtherUNIVERSAL
FL43600YMedicare PIN
FL1193424OtherWELLCARE
FL23162OtherMEDICA