Healthcare Provider Details

I. General information

NPI: 1942406822
Provider Name (Legal Business Name): JENNY COUNCIL ZAGARIA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNY ELIZABETH COUNCIL D.O.

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI BEACH FL
33140-2800
US

IV. Provider business mailing address

9225 CHELSEA DR N
PLANTATION FL
33324-6262
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2310
  • Fax:
Mailing address:
  • Phone: 954-593-5087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS9861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: