Provider Demographics
NPI:1457393324
Name:ZUBKIN, ALLAN (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:ZUBKIN
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 1:15848 TOWER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-9597
Mailing Address - Country:US
Mailing Address - Phone:407-405-1055
Mailing Address - Fax:352-343-8801
Practice Address - Street 1:131 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3809
Practice Address - Country:US
Practice Address - Phone:407-405-1055
Practice Address - Fax:352-343-8801
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56047207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061988400Medicaid
FLB36260Medicare UPIN