Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | POR69 | FL |
N | 222Z00000X | Podiatrist | POR69 | FL |
N | 224P00000X | Prosthetist | POR69 | FL |
NPI | 1174604219 |
---|---|
Provider Name | Mr. Jonathan Shochat |
First Address | Boynton Beach, FL 33436-6634 |
Second Address | Boynton Beach, FL 33436-6634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |