Healthcare Provider Details

I. General information

NPI: 1700278322
Provider Name (Legal Business Name): ERIC ZEPHIRIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 SW 37 AVE #101
MIAMI FL
33133
US

IV. Provider business mailing address

2645 SW 37 AVE #101
MIAMI FL
33133
US

V. Phone/Fax

Practice location:
  • Phone: 305-444-7114
  • Fax: 305-444-9587
Mailing address:
  • Phone: 305-444-7114
  • Fax: 305-444-9587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3790
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: