Provider Demographics
NPI:1801020318
Name:ZSUZSANNA SEYBOLD MDPA
Entity Type:Organization
Organization Name:ZSUZSANNA SEYBOLD MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ZSUZSANNA
Authorized Official - Middle Name:VEREBELYI
Authorized Official - Last Name:SEYBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-415-3161
Mailing Address - Street 1:2630 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-4471
Mailing Address - Country:US
Mailing Address - Phone:954-415-3161
Mailing Address - Fax:953-473-8788
Practice Address - Street 1:7200 NW 7TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2948
Practice Address - Country:US
Practice Address - Phone:954-415-3161
Practice Address - Fax:953-473-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME906162083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty