Healthcare Provider Details

I. General information

NPI: 1669593323
Provider Name (Legal Business Name): EVAN J ZIMMER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 ARTHUR GODFREY RD SUITE 308
MIAMI FL
33140-3329
US

IV. Provider business mailing address

7100 HOLLYWOOD BLVD SUITE 23
PEMBROKE PINES FL
33024-7355
US

V. Phone/Fax

Practice location:
  • Phone: 305-673-3101
  • Fax:
Mailing address:
  • Phone: 305-673-3101
  • Fax: 954-967-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: EVAN J ZIMMER
Title or Position: OWNER
Credential: MD
Phone: 305-673-3101