Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 3442 | FL |
NPI | 1104121870 |
---|---|
Provider Name | Nooshin Zolfaghari |
First Address | Pembroke Pines, FL 33027-6107 |
Second Address | Fort Lauderdale, FL 33312-6517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2011 |
Last Update Date | 12/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004505600 | (05) | FL |
6504N | BCBS (01) | FL |
FU268Z | (02) | FL |