Provider Demographics
NPI:1235611534
Name:CARY M ZINKIN DPM, PA
Entity Type:Organization
Organization Name:CARY M ZINKIN DPM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-436-0555
Mailing Address - Street 1:1300 CONCORD TER STE 210
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2899
Mailing Address - Country:US
Mailing Address - Phone:954-505-5000
Mailing Address - Fax:954-838-9660
Practice Address - Street 1:12177 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-1727
Practice Address - Country:US
Practice Address - Phone:954-436-0555
Practice Address - Fax:954-436-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1849213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty