=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225339690
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARY M ZINKIN DPM, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2010
-----------------------------------------------------
Last Update Date | 12/12/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1979 W HILLSBORO BLVD SUITE 2
-----------------------------------------------------
City | DEERFIELD BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33442-1444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-426-8833
-----------------------------------------------------
Fax | 954-426-9975
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 4997
-----------------------------------------------------
City | DEERFIELD BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33442-4997
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-426-8833
-----------------------------------------------------
Fax | 954-426-9975
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. CARY ZINKIN
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 954-426-8833
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | PO 1849
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------