Provider Demographics
NPI:1164480075
Name:ZIMMERMAN, PAUL (MD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:ZIMMERMAN
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 1:2901 SW 149TH AVE.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027
Mailing Address - Country:US
Mailing Address - Phone:954-874-4612
Mailing Address - Fax:305-594-2722
Practice Address - Street 1:2901 SW 149TH AVE.
Practice Address - Street 2:SUITE 400
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027
Practice Address - Country:US
Practice Address - Phone:954-874-4612
Practice Address - Fax:305-594-2722
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047137207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD64934Medicare UPIN