Healthcare Provider Details
I. General information
NPI: 1912317769
Provider Name (Legal Business Name): ZEPHIR MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2014
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
28899 SOUTH DIXIE HIGHWAY
NARANJA FL
33030
US
IV. Provider business mailing address
28899 S DIXIE HWY
HOMESTEAD FL
33033-2406
US
V. Phone/Fax
- Phone: 786-298-7236
- Fax:
- Phone: 786-298-7236
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | OS11818 |
| License Number State | FL |
VIII. Authorized Official
Name:
JOHANNE
A
ZEPHIR
Title or Position: OWNER
Credential: DO
Phone: 305-247-7500