Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | ME46333 | FL |
NPI | 1265432785 |
---|---|
Provider Name | Bruce M Zafran |
First Address | Coral Springs, FL 33065-5795 |
Second Address | Coral Springs, FL 33065-5795 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 01/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040159500 | (05) | FL |
20071 | BLUE CROSS BLUE SHIELD (01) |