Provider Demographics
NPI:1043217235
Name:ZWICK, THOMAS GERARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERARD
Last Name:ZWICK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:8200 NW 27 ST
Mailing Address - Street 2:STE 108
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1906
Mailing Address - Country:US
Mailing Address - Phone:786-662-3893
Mailing Address - Fax:786-662-3899
Practice Address - Street 1:1321 NW 14TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1653
Practice Address - Country:US
Practice Address - Phone:305-326-3338
Practice Address - Fax:305-326-3339
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO 2255213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390225100Medicaid
FL390225100Medicaid
FL4672340001Medicare NSC
FLU40425Medicare UPIN