Provider Demographics
NPI:1174604219
Name:SHOCHAT, JONATHAN (LPO)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:SHOCHAT
Suffix:
Gender:M
Credentials:LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 W WOOLBRIGHT ROAOD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-6634
Mailing Address - Country:US
Mailing Address - Phone:561-572-0305
Mailing Address - Fax:561-572-0348
Practice Address - Street 1:2609 W WOOLBRIGHT RD
Practice Address - Street 2:SUITE 3A
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-6634
Practice Address - Country:US
Practice Address - Phone:561-572-0305
Practice Address - Fax:561-572-0348
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR69222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5690060001Medicare ID - Type Unspecified