Individual
MARK SHACHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 CORAL HILLS DR, SUITE 320, CORAL SPRINGS, FL 33065-4172
(954) 755-0111
(954) 755-2209
Mailing address
3001 CORAL HILLS DR, SUITE 320, CORAL SPRINGS, FL 33065-4172
(954) 755-0111
(954) 755-2209
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0062046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002683
NHP
FL
01
—
0100553
GHI
FL
01
—
0163178
GHI
FL
01
—
14969
BLUECROSSBLUESHIELD
FL
01
—
204679
AVMED
FL
05
—
370302900
—
FL
01
—
P00811387
MEDICARE RAILROAD
FL
Enumeration date
08/11/2005
Last updated
11/10/2010
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