Provider Demographics
NPI:1073504825
Name:ZABALA, ARMANDO (MD)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:ZABALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 S DOUGLAS RD
Mailing Address - Street 2:STE 308
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6134
Mailing Address - Country:US
Mailing Address - Phone:305-804-1152
Mailing Address - Fax:305-597-0817
Practice Address - Street 1:10525 NW 43RD TER
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2265
Practice Address - Country:US
Practice Address - Phone:305-804-1152
Practice Address - Fax:305-597-0817
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-01
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35607Medicare PIN
FL35607XMedicare PIN
FLE62909Medicare UPIN