Healthcare Provider Details

I. General information

NPI: 1801020318
Provider Name (Legal Business Name): ZSUZSANNA SEYBOLD MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 NW 7TH ST SUITE 206
MIAMI FL
33126-2948
US

IV. Provider business mailing address

2630 SW 20TH ST
FORT LAUDERDALE FL
33312-4471
US

V. Phone/Fax

Practice location:
  • Phone: 954-415-3161
  • Fax: 953-473-8788
Mailing address:
  • Phone: 954-415-3161
  • Fax: 953-473-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberME90616
License Number StateFL

VIII. Authorized Official

Name: ZSUZSANNA VEREBELYI SEYBOLD
Title or Position: MEDICAL PROVIDER
Credential: MD
Phone: 954-415-3161