Provider Demographics
NPI:1588852743
Name:LUIS MANUEL ZAVALA, M.D.,P.A.
Entity Type:Organization
Organization Name:LUIS MANUEL ZAVALA, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:ZAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-661-8288
Mailing Address - Street 1:7600 SW 57TH AVE
Mailing Address - Street 2:STE. 304
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5428
Mailing Address - Country:US
Mailing Address - Phone:305-661-8288
Mailing Address - Fax:305-661-1874
Practice Address - Street 1:7600 SW 57TH AVE
Practice Address - Street 2:STE. 304
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5428
Practice Address - Country:US
Practice Address - Phone:305-661-8288
Practice Address - Fax:305-661-1874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102624207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty