Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DN 21419 | FL |
NPI | 1013315647 |
---|---|
Provider Name | Dr. Jamie T. Zupnik |
First Address | Coral Gables, FL 33134-5730 |
Second Address | Coral Gables, FL 33134-5730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2014 |
Last Update Date | 29/11/2015 |