MEDICARE: DR. ZACHARY AUSTIN WICHNER D.O., MPH

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	208M00000X	Hospitalist Physician	UO 3333	FL
2	207L00000X	Anesthesiology Physician	OS15307	FL
3	207L00000X	Anesthesiology Physician	UO 3333	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	:	1780929745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZACHARY AUSTIN WICHNER D.O., MPH

Provider Business Mailing Address
First Line	:	5681 SW 6TH ST
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-4340
Country	:	US
Telephone Number	:	546-661-8471
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 JOE DIMAGGIO DR
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5487
Country	:	US
Telephone Number	:	954-661-8471
Fax Number	:

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

Provider Enumeration Date	:	12/03/2012
Last Update Date	:	10/09/2025

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Directions to “ DR. ZACHARY AUSTIN WICHNER D.O., MPH” Practice Location

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