Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | ME30033 | FL |
NPI | 1649483256 |
---|---|
Provider Name | Martin R Zfaz |
First Address | Oakland Park, FL 33334-3928 |
Second Address | Jacksonville, FL 32216-1981 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D65328 | (02) | FL |