Healthcare Provider Details
I. General information
NPI: 1164480075
Provider Name (Legal Business Name): PAUL ZIMMERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/02/2006
Last Update Date: 05/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2901 SW 149TH AVE. SUITE 400
MIRAMAR FL
33027
US
IV. Provider business mailing address
2901 SW 149TH AVE. SUITE 400
MIRAMAR FL
33027
US
V. Phone/Fax
- Phone: 954-874-4612
- Fax: 305-594-2722
- Phone: 954-874-4612
- Fax: 305-594-2722
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | ME0047137 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: