Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | ME56047 | FL |
NPI | 1457393324 |
---|---|
Provider Name | Allan Zubkin |
First Address | Clermont, FL 34711-9597 |
Second Address | Tavares, FL 32778-3809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 29/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061988400 | (05) | FL |
B36260 | (02) | FL |