MEDICARE: DR. ISRAEL WIZNITZER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RX0202X	Medical Oncology Physician	ME84626	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	62700	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720013790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISRAEL WIZNITZER MD

Provider Business Mailing Address
First Line	:	12309 PEMBROKE RD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-1723
Country	:	US
Telephone Number	:	954-432-6595
Fax Number	:	954-324-6266

Provider Business Practice Location Address
First Line	:	8395 W OAKLAND PARK BLVD
Second Line	:	STE A
City	:	SUNRISE
State	:	FL
Zip	:	33351-7301
Country	:	US
Telephone Number	:	954-747-6220
Fax Number	:	954-747-6228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	10/06/2023

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