Provider Demographics
NPI:1497742258
Name:ZELTSMAN, MARAT (DO)
Entity Type:Individual
Prefix:
First Name:MARAT
Middle Name:
Last Name:ZELTSMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:305-682-9877
Mailing Address - Fax:305-682-1602
Practice Address - Street 1:21097 NE 27TH CT
Practice Address - Street 2:205
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1204
Practice Address - Country:US
Practice Address - Phone:305-682-9877
Practice Address - Fax:305-682-1602
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9168208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272768400Medicaid