Provider Demographics
NPI:1073607560
Name:KAZAMIAS, MICHAEL T (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:KAZAMIAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7512 COLONY LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1308
Mailing Address - Country:US
Mailing Address - Phone:561-963-7465
Mailing Address - Fax:561-963-7465
Practice Address - Street 1:7512 COLONY LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-1308
Practice Address - Country:US
Practice Address - Phone:561-963-7465
Practice Address - Fax:561-963-7465
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2606213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU64185Medicare UPIN