Provider Demographics
NPI:1033894092
Name:ZUIDERVEEN, AUBRIE JOY (DMD)
Entity Type:Individual
Prefix:DR
First Name:AUBRIE
Middle Name:JOY
Last Name:ZUIDERVEEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 MCGREGOR BLVD APT 1414
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-3460
Mailing Address - Country:US
Mailing Address - Phone:616-644-5668
Mailing Address - Fax:
Practice Address - Street 1:5037 S CLEVELAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1377
Practice Address - Country:US
Practice Address - Phone:239-236-2103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN28039122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist