Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME 44137 | FL |
NPI | 1265428809 |
---|---|
Provider Name | Dr. Thomas John Zaydon JR. |
First Address | Miami, FL 33133-4236 |
Second Address | Miami, FL 33133-4236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 28/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D64898 | (02) | FL |