MEDICARE: ZACHARIAH P ZACHARIAH 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	207R00000X	Internal Medicine Physician	ME27175	FL
2	207RC0000X	Cardiovascular Disease Physician	ME27175	FL
3	207RI0011X	Interventional Cardiology Physician	ME27175	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275511289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARIAH P ZACHARIAH MD

Provider Business Mailing Address
First Line	:	4800 NE 20TH TER STE 201
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4510
Country	:	US
Telephone Number	:	954-772-2200
Fax Number	:	954-772-2236

Provider Business Practice Location Address
First Line	:	4800 NE 20TH TER STE 201
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4510
Country	:	US
Telephone Number	:	954-772-2200
Fax Number	:	954-772-2236

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	04/20/2023

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Directions to “ ZACHARIAH P ZACHARIAH MD” Practice Location

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