Provider Demographics
NPI:1598720203
Name:ZALAZNICK, HARVEY (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:
Last Name:ZALAZNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18999 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2814
Mailing Address - Country:US
Mailing Address - Phone:305-931-2673
Mailing Address - Fax:305-933-0895
Practice Address - Street 1:18999 BISCAYNE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2814
Practice Address - Country:US
Practice Address - Phone:305-931-2673
Practice Address - Fax:305-933-0895
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0024921174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79072Medicare ID - Type Unspecified
FLD58636Medicare UPIN