Provider Demographics
NPI:1619997764
Name:ZAMBRANO, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ZAMBRANO
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 1:15600 NW 67TH AVE
Mailing Address - Street 2:210
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2174
Mailing Address - Country:US
Mailing Address - Phone:305-825-2020
Mailing Address - Fax:305-556-0557
Practice Address - Street 1:15600 NW 67TH AVE
Practice Address - Street 2:210
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2174
Practice Address - Country:US
Practice Address - Phone:305-825-2020
Practice Address - Fax:305-556-0557
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047462207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048266800Medicaid
FL048266801Medicaid
FL048266801Medicaid
FL05691Medicare ID - Type Unspecified