Healthcare Provider Details

I. General information

NPI: 1891957601
Provider Name (Legal Business Name): JASON MICHAEL ZYLBERING DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 NW 2ND AVE SUITE 102
BOCA RATON FL
33431-7456
US

IV. Provider business mailing address

6422 COLLINS AVE APT 401
MIAMI BEACH FL
33141-4660
US

V. Phone/Fax

Practice location:
  • Phone: 561-226-0100
  • Fax:
Mailing address:
  • Phone: 305-316-6757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN18248
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: