Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH5732 | FL |
NPI | 1104958602 |
---|---|
Provider Name | Dr. Mark Zulovitz II |
First Address | Vero Beach, FL 32961-1630 |
Second Address | Vero Beach, FL 32960-4311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22281 | (02) | FL |