Basic Information
| Provider Information | |||||||||
| NPI: | 1922068436 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PACHTER | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 N FLAMINGO RD | ||||||||
| Address2: | STE. 402 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330281015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547043900 | ||||||||
| FaxNumber: | 9547011424 | ||||||||
| Practice Location | |||||||||
| Address1: | 2234 COLONIAL BLVD | ||||||||
| Address2: | ATTN: PAYER CONTRACTING & RELATIONS | ||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339071412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399317342 | ||||||||
| FaxNumber: | 2399317385 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 05/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | ME76080 | FL | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 7006030 | 01 | FL | AETNA | OTHER | P01710335 | 01 | FL | SIMPLY HEALTHCARE | OTHER | 242805 | 01 | FL | AVMED | OTHER | P00280681 | 01 | FL | RAILROAD MEDICARE | OTHER | 0181691 | 01 | FL | CIGNA | OTHER | 23162 | 01 | FL | MEDICA | OTHER | 43600 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER | P01027499 | 01 | FL | RAILROAD MCR | OTHER | 029734 | 01 | FL | NHP | OTHER | 255098900 | 05 | FL | MEDICAID | 2252476 | 01 | FL | AETNA | OTHER | F00184753802 | 01 | FL | UNITED HEALTHCARE | OTHER | 1193424 | 01 | FL | WELLCARE | OTHER | 48795 | 01 | FL | UNIVERSAL | OTHER |