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General NPI Number Information
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NPI Number | 1356098875
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Entity Type | Individual
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Provider Name | MIRA ZEITLIN
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Gender | Female
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 2500 E HALLANDALE BEACH BLVD STE 609
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4839
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Country | US
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Telephone | 954-333-8665
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Fax |
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Provider Business Mailing Address
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Address Line | 1865 S OCEAN DR APT 10B
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-7604
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Country | US
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Telephone | 954-608-4586
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11017945
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License Number State | FL
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