Provider Demographics
NPI:1790031490
Name:ZHUK, MARK (MD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:ZHUK
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 1:2925 AVENTURA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3124
Mailing Address - Country:US
Mailing Address - Phone:305-692-2222
Mailing Address - Fax:
Practice Address - Street 1:405 N HIBISCUS DR
Practice Address - Street 2:UNIT 207
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5169
Practice Address - Country:US
Practice Address - Phone:305-799-5133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79113208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice