Healthcare Provider Details

I. General information

NPI: 1689932824
Provider Name (Legal Business Name): ROBERTO IVAN SCHNAKOFSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SW 73RD ST ANESTHESIA ASSOCIATES OF GREATER MIAMI
SOUTH MIAMI FL
33143-4679
US

IV. Provider business mailing address

4651 LITTLE PALM LN
COCONUT CREEK FL
33073-5114
US

V. Phone/Fax

Practice location:
  • Phone: 305-740-0853
  • Fax:
Mailing address:
  • Phone: 954-478-7134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME 127005
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: