Healthcare Provider Details

I. General information

NPI: 1730211608
Provider Name (Legal Business Name): STEPHEN ZUCKERMAN DOM, AP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 N FEDERAL HWY SUITE D304
BOCA RATON FL
33431-5188
US

IV. Provider business mailing address

4800 N FEDERAL HWY SUITE D304
BOCA RATON FL
33431-5188
US

V. Phone/Fax

Practice location:
  • Phone: 561-338-3337
  • Fax: 561-338-4805
Mailing address:
  • Phone: 561-338-3337
  • Fax: 561-338-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP1194
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: