Provider Demographics
NPI:1306815675
Name:MARCANO, ZAIDA IVETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZAIDA
Middle Name:IVETTE
Last Name:MARCANO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 S GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33875-5847
Mailing Address - Country:US
Mailing Address - Phone:863-386-6040
Mailing Address - Fax:863-386-6048
Practice Address - Street 1:7205 S GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-5847
Practice Address - Country:US
Practice Address - Phone:863-386-6040
Practice Address - Fax:863-386-6048
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2901015850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075914700Medicaid