MEDICARE: DR. THEODORE ZARAVINOS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	ME36966	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922034560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE ZARAVINOS M.D.

Provider Business Mailing Address
First Line	:	5700 N FEDERAL HWY
Second Line	:	SUITE 5
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-2600
Country	:	US
Telephone Number	:	954-776-1800
Fax Number	:	954-776-3647

Provider Business Practice Location Address
First Line	:	5700 N FEDERAL HWY
Second Line	:	SUITE 5
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-2600
Country	:	US
Telephone Number	:	954-776-1800
Fax Number	:	954-776-3647

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	06/25/2019

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Directions to “ DR. THEODORE ZARAVINOS M.D.” Practice Location

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