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General NPI Number Information
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NPI Number | 1821251893
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Entity Type | Individual
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Provider Name | MIRIAM CHRISTINE ZOLFOGHARY MD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 1206 COUNTRY CLUB BLVD
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City | CAPE CORAL
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State | FL
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Zip | 33990-2180
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Country | US
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Telephone | 239-574-7454
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Fax | 239-574-9439
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME101389
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License Number State | FL
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