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General NPI Number Information
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NPI Number | 1851305635
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Entity Type | Individual
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Provider Name | SCOTT D. KAZDAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 601 N FLAMINGO RD 209
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1015
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Country | US
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Telephone | 954-442-7616
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Fax | 954-442-6234
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Provider Business Mailing Address
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Address Line | 601 N FLAMINGO RD 209
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1015
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Country | US
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Telephone | 954-442-7616
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Fax | 954-442-6234
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | OS0006354
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License Number State | FL
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