Healthcare Provider Details
I. General information
NPI: 1538143854
Provider Name (Legal Business Name): DARYOUSH A ZAFAR DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/30/2005
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9250 CORKSCREW RD SUITE 7
ESTERO FL
33928-3208
US
IV. Provider business mailing address
8851 BOARDROOM CIRCLE
FT MYERS FL
33919-4888
US
V. Phone/Fax
- Phone: 239-481-7000
- Fax: 239-481-8150
- Phone: 239-481-7000
- Fax: 239-481-8150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | PO2799 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: