Provider Demographics
NPI:1235860040
Name:ZUMARAN, DIANA (DMD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:ZUMARAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 BLUE HERON DR APT 208
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5787
Mailing Address - Country:US
Mailing Address - Phone:954-699-1429
Mailing Address - Fax:
Practice Address - Street 1:3980 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3434
Practice Address - Country:US
Practice Address - Phone:954-699-1429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27088122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist