Provider Demographics
NPI:1780859918
Name:ZULUAGA TORO, TANIA (MD)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:ZULUAGA TORO
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 1:3501 JOHNSON ST
Mailing Address - Street 2:ROOM 2-281M
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5421
Mailing Address - Country:US
Mailing Address - Phone:954-265-2333
Mailing Address - Fax:954-967-7630
Practice Address - Street 1:3501 JOHNSON ST
Practice Address - Street 2:ROOM 2-281M
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5421
Practice Address - Country:US
Practice Address - Phone:954-265-2333
Practice Address - Fax:954-967-7630
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000043247207ZP0102X
FLME107726207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002533900Medicaid
FL002533900Medicaid