1972008308 NPI number — ERNESTO ALEJANDRO ZAMORA MD

Table of content: ERNESTO ALEJANDRO ZAMORA MD (NPI 1972008308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972008308 NPI number — ERNESTO ALEJANDRO ZAMORA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAMORA
Provider First Name:
ERNESTO
Provider Middle Name:
ALEJANDRO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972008308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5101 SW 8TH STREET
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33134-2442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-262-6060
Provider Business Mailing Address Fax Number:
305-262-6038

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9380 SW 150TH STREET
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33176-7947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-634-4991
Provider Business Practice Location Address Fax Number:
786-361-1162
Provider Enumeration Date:
03/27/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  BP10074389 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: ME167316 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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