Healthcare Provider Details

I. General information

NPI: 1467789727
Provider Name (Legal Business Name): JOHANNE A ZEPHIR D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 W MOWRY DR
HOMESTEAD FL
33030-5746
US

IV. Provider business mailing address

10300 SW 216TH ST
CUTLER BAY FL
33190-1003
US

V. Phone/Fax

Practice location:
  • Phone: 305-253-5100
  • Fax: 305-254-4967
Mailing address:
  • Phone: 305-253-5100
  • Fax: 305-247-7536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS11818
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: