Provider Demographics
NPI:1730256512
Name:ZALCBERG-ZUBATA, LAURA JUDITH (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JUDITH
Last Name:ZALCBERG-ZUBATA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:JUDITH
Other - Last Name:ZALCBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0878
Mailing Address - Country:US
Mailing Address - Phone:689-223-3898
Mailing Address - Fax:689-223-3898
Practice Address - Street 1:20803 BISCAYNE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1429
Practice Address - Country:US
Practice Address - Phone:305-931-9002
Practice Address - Fax:305-692-9176
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79608207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259125100Medicaid
FLE4106VMedicare ID - Type Unspecified