Provider Demographics
NPI:1801805734
Name:ZACHAROUDIS, ARISTIDES (MD)
Entity type:Individual
Prefix:
First Name:ARISTIDES
Middle Name:
Last Name:ZACHAROUDIS
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 1:5333 NORTH DIXIE HWY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3454
Mailing Address - Country:US
Mailing Address - Phone:954-202-0555
Mailing Address - Fax:954-202-0607
Practice Address - Street 1:5333 N DIXIE HWY STE 208
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3454
Practice Address - Country:US
Practice Address - Phone:954-202-0555
Practice Address - Fax:954-202-0607
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68303207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ014691Medicaid
TN6044738OtherBLUE CROSS/BLUE SHIELD
FLF73877Medicare UPIN
TNQ014691Medicaid
TNQ014691Medicaid