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General NPI Number Information
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NPI Number | 1083082721
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Entity Type | Individual
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Provider Name | SAMUEL JOSEPH ZAYDON M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 18141 SW 89TH AVE
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City | PALMETTO BAY
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State | FL
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Zip | 33157-5978
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Country | US
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Telephone | 786-269-7777
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 511151
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City | KEY COLONY BEACH
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State | FL
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Zip | 33051-1151
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Country | US
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Telephone | 786-269-7777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME0042525
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License Number State | FL
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