Basic Information
| Provider Information | |||||||||
| NPI: | 1942232335 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHACHNER AND ZARAGOZA MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3001 CORAL HILLS DR | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330654172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547550111 | ||||||||
| FaxNumber: | 9547552209 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 CORAL HILLS DR | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330654172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547550111 | ||||||||
| FaxNumber: | 9547552209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 11/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | SHACHNER | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9547550111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 256601000 | 05 | FL | MEDICAID |