Provider Demographics
NPI:1669739173
Name:CAPOSOLE, MICHAEL ZACHARY (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ZACHARY
Last Name:CAPOSOLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7950 SW 30TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1979
Mailing Address - Country:US
Mailing Address - Phone:754-247-2684
Mailing Address - Fax:
Practice Address - Street 1:7950 SW 30TH ST STE 201
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1979
Practice Address - Country:US
Practice Address - Phone:754-247-2684
Practice Address - Fax:954-252-4534
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15785208600000X
ALDO.1917208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery