Provider Demographics
NPI:1376592048
Name:KAZDAN, TODD JAY (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:JAY
Last Name:KAZDAN
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:6099 STIRLING RD
Mailing Address - Street 2:219-222
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7234
Mailing Address - Country:US
Mailing Address - Phone:954-581-7660
Mailing Address - Fax:954-587-2075
Practice Address - Street 1:6099 STIRLING RD
Practice Address - Street 2:219-222
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7234
Practice Address - Country:US
Practice Address - Phone:954-581-7660
Practice Address - Fax:954-587-2075
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH66801Medicare UPIN