MEDICARE: MARYAM BELLA ZARGAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30501	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1477343341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYAM BELLA ZARGAR

Provider Business Mailing Address
First Line	:	7859 SPRINGVALE DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7347
Country	:	US
Telephone Number	:	202-802-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 DUNLAWTON AVE STE 101
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-2925
Country	:	US
Telephone Number	:	386-233-3040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	06/18/2025

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Directions to “ MARYAM BELLA ZARGAR ” Practice Location

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