Provider Demographics
NPI:1952419145
Name:SHECHTER, ODED (MD)
Entity Type:Individual
Prefix:
First Name:ODED
Middle Name:
Last Name:SHECHTER
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 1:3001 NW 49TH AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7262
Mailing Address - Country:US
Mailing Address - Phone:954-486-7224
Mailing Address - Fax:954-653-0469
Practice Address - Street 1:3001 NW 49TH AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7262
Practice Address - Country:US
Practice Address - Phone:954-486-7224
Practice Address - Fax:954-653-0469
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E19730Medicare UPIN
96061Medicare ID - Type Unspecified