Healthcare Provider Details

I. General information

NPI: 1669030409
Provider Name (Legal Business Name): ASHVIN BABU ZACHARIAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 LAKE WORTH RD STE 100
WELLINGTON FL
33467
US

IV. Provider business mailing address

7593 W BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-5033
  • Fax:
Mailing address:
  • Phone: 561-649-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME170447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: