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General NPI Number Information
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NPI Number | 1245802396
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Entity Type | Organization
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Legal Business Name | ALPHA DNA HEALTH, LLC
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 7750 NOVA DR STE A4
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City | DAVIE
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State | FL
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Zip | 33324-5801
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Country | US
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Telephone | 954-944-1143
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Fax |
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Provider Business Mailing Address
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Address Line | 7750 NOVA DR STE A4
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City | DAVIE
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State | FL
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Zip | 33324-5801
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Country | US
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Telephone | 954-944-1143
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MR. WILLIAM MAZZEI III
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Credential | MD
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Telephone | 561-479-0774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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