Provider Demographics
NPI:1841235165
Name:CHARLES P SHENKER MD PA
Entity type:Organization
Organization Name:CHARLES P SHENKER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SHENKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-705-0501
Mailing Address - Street 1:21150 BISCAYNE BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1226
Mailing Address - Country:US
Mailing Address - Phone:305-705-0501
Mailing Address - Fax:305-705-0502
Practice Address - Street 1:21150 BISCAYNE BLVD
Practice Address - Street 2:STE 208
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1226
Practice Address - Country:US
Practice Address - Phone:305-705-0501
Practice Address - Fax:305-705-0502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4192330001Medicare NSC
FL92867Medicare PIN
D60219Medicare UPIN