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General NPI Number Information
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NPI Number | 1780929745
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Entity Type | Individual
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Provider Name | ZACHARY AUSTIN WICHNER D.O., MPH
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Gender | Male
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1005 JOE DIMAGGIO DR
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5487
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Country | US
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Telephone | 954-661-8471
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Fax |
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Provider Business Mailing Address
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Address Line | 5681 SW 6TH ST
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City | PLANTATION
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State | FL
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Zip | 33317-4340
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Country | US
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Telephone | 546-661-8471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | UO 3333
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | OS15307
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | UO 3333
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License Number State | FL
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