Provider Demographics
NPI:1861562282
Name:SCHWALB, IRA (MD)
Entity type:Individual
Prefix:DR
First Name:IRA
Middle Name:
Last Name:SCHWALB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 S OCEAN DR APT 804
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7719
Mailing Address - Country:US
Mailing Address - Phone:650-996-7853
Mailing Address - Fax:
Practice Address - Street 1:20601 E DIXIE HWY STE 400
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1542
Practice Address - Country:US
Practice Address - Phone:650-996-7853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57261207L00000X
FLME143548207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0042170Medicaid
CAC34676Medicare UPIN
CA00G572610Medicare ID - Type UnspecifiedMEDICARE NO.