Provider Demographics
NPI:1689606162
Name:HRDLICKA, ZUZANA K (MD)
Entity Type:Individual
Prefix:
First Name:ZUZANA
Middle Name:K
Last Name:HRDLICKA
Suffix:
Gender:F
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:P.O. BOX 39209
Mailing Address - Street 2:STE 115
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339
Mailing Address - Country:US
Mailing Address - Phone:954-851-9966
Mailing Address - Fax:954-318-7360
Practice Address - Street 1:5601 N. DIXIE HWY
Practice Address - Street 2:STE. 115
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334
Practice Address - Country:US
Practice Address - Phone:954-771-4271
Practice Address - Fax:954-776-5959
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073617174400000X
FLME73617207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35282OtherINDIVIDUAL BCBS
FLP00173686OtherRAILROAD MEDICARE
FL266480100Medicaid
E4623XMedicare PIN
FLG34492Medicare UPIN
FLE4623XMedicare PIN