Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN23517 | FL |
N | 204E00000X | Oral & Maxillofacial Surgeon | DN23517 | FL |
NPI | 1497065775 |
---|---|
Provider Name | Dr. Joseph Zeidan |
First Address | New Haven, CT 06510-3220 |
Second Address | Tampa, FL 33607-6451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2010 |
Last Update Date | 02/10/2018 |