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General NPI Number Information
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NPI Number | 1750747374
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Entity Type | Organization
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Legal Business Name | ZULMA CASTANEDA-MEDINA DMD PA
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 5558 S FLAMINGO RD SUITE 43
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City | COOPER CITY
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State | FL
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Zip | 33330-2700
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Country | US
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Telephone | 954-434-3043
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Fax | 954-434-3044
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Provider Business Mailing Address
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Address Line | 5558 S FLAMINGO RD SUITE 43
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City | COOPER CITY
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State | FL
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Zip | 33330-2700
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Country | US
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Telephone | 954-434-3043
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Fax | 954-434-3044
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Authorized Official
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Title or Position | OWNER
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Name | DR. ZULMA CASTANEDA-MEDINA
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Credential | DMD
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Telephone | 954-434-3043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN 19707
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License Number State | FL
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