Healthcare Provider Details

I. General information

NPI: 1477449213
Provider Name (Legal Business Name): SAMUEL CHEREM ZAGA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVENUE DEPARTMENT OF PEDIATRICS, HOLTZ CHILDRENS HOSPITAL
MIAMI FL
33136
US

IV. Provider business mailing address

1611 NW 12TH AVENUE DEPARTMENT OF PEDIATRICS, HOLTZ CHILDRENS HOSPITAL
MIAMI FL
33136
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6042
  • Fax:
Mailing address:
  • Phone: 305-585-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: