Provider Demographics
NPI:1649483256
Name:ZFAZ, MARTIN R (DO)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:R
Last Name:ZFAZ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4825 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3928
Mailing Address - Country:US
Mailing Address - Phone:954-489-2580
Mailing Address - Fax:954-491-4193
Practice Address - Street 1:8889 CORPORATE SQUARE CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1981
Practice Address - Country:US
Practice Address - Phone:904-727-6455
Practice Address - Fax:904-855-4365
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME30033207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD65328Medicare UPIN