Healthcare Provider Details

I. General information

NPI: 1447247341
Provider Name (Legal Business Name): GREGORIO B ZUAZU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6039 COLLINS AVENUE APT 1115
MIAMI BEACH FL
33140-2252
US

IV. Provider business mailing address

6039 COLLINS AVENUE APT 1115
MIAMI BEACH FL
33140-2252
US

V. Phone/Fax

Practice location:
  • Phone: 713-542-4522
  • Fax:
Mailing address:
  • Phone: 713-542-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME39137
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: