Healthcare Provider Details
I. General information
NPI: 1336272608
Provider Name (Legal Business Name): ZHIFENG HUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14932 PINES BLVD
PEMBROKE PINES FL
33027-1213
US
IV. Provider business mailing address
16766 SW 51ST ST
MIRAMAR FL
33027-4917
US
V. Phone/Fax
- Phone: 954-362-4106
- Fax: 954-362-4106
- Phone: 954-235-5361
- Fax: 954-235-5361
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | ME80400 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: