Provider Demographics
NPI:1992120356
Name:OZERI, NACHUM SHALOM (DO)
Entity type:Individual
Prefix:DR
First Name:NACHUM
Middle Name:SHALOM
Last Name:OZERI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 W PALMETTO PARK RD STE 106C
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3458
Mailing Address - Country:US
Mailing Address - Phone:561-483-1125
Mailing Address - Fax:877-460-1537
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 106C
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3458
Practice Address - Country:US
Practice Address - Phone:561-483-1125
Practice Address - Fax:877-460-1537
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0105652-0384208600000X
FLOS14352207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBC5738387-0384OtherDEA