Provider Demographics
NPI:1235233735
Name:ZLOCZOVER, GERARDO (MD)
Entity Type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:ZLOCZOVER
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 1:1325 S CONGRESS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5802
Mailing Address - Country:US
Mailing Address - Phone:561-737-5301
Mailing Address - Fax:561-738-5199
Practice Address - Street 1:1325 S CONGRESS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5876
Practice Address - Country:US
Practice Address - Phone:561-737-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0033739207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79465Medicare ID - Type UnspecifiedMEDICARE PERSONAL ID#
FLD31867Medicare UPIN