Provider Demographics
NPI:1467478073
Name:MIRAMAR FAMILY DENTISTRY
Entity Type:Organization
Organization Name:MIRAMAR FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:T
Authorized Official - Last Name:ZIADIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-987-7007
Mailing Address - Street 1:7959 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5877
Mailing Address - Country:US
Mailing Address - Phone:954-987-7007
Mailing Address - Fax:954-983-4911
Practice Address - Street 1:7959 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5877
Practice Address - Country:US
Practice Address - Phone:954-987-7007
Practice Address - Fax:954-983-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty