Provider Demographics
NPI:1811939754
Name:MARTIN N ZAIAC, M.D., LLC
Entity type:Organization
Organization Name:MARTIN N ZAIAC, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ONELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-532-4478
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 750
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-532-4478
Mailing Address - Fax:305-532-9753
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 750
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-532-4478
Practice Address - Fax:305-532-9753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052392500Medicaid
FL00276Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER