Healthcare Provider Details

I. General information

NPI: 1093764243
Provider Name (Legal Business Name): SETH CHARLES WACHSMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S PINE ISLAND RD STE 300
PLANTATION FL
33324-3179
US

IV. Provider business mailing address

8880 ROYAL PALM BLVD SUITE 103
CORAL SPRINGS FL
33076-3306
US

V. Phone/Fax

Practice location:
  • Phone: 954-473-6344
  • Fax: 954-476-9077
Mailing address:
  • Phone: 954-975-8233
  • Fax: 954-974-2335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME75168
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: