Provider Demographics
NPI:1942232335
Name:SHACHNER AND ZARAGOZA MD PA
Entity Type:Organization
Organization Name:SHACHNER AND ZARAGOZA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHACHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-755-0111
Mailing Address - Street 1:3001 CORAL HILLS DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4172
Mailing Address - Country:US
Mailing Address - Phone:954-755-0111
Mailing Address - Fax:954-755-2209
Practice Address - Street 1:3001 CORAL HILLS DR
Practice Address - Street 2:SUITE 320
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4172
Practice Address - Country:US
Practice Address - Phone:954-755-0111
Practice Address - Fax:954-755-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256601000Medicaid
FL256601000Medicaid