Provider Demographics
NPI:1982718698
Name:POTPARIC, ZORAN (MD)
Entity Type:Individual
Prefix:MR
First Name:ZORAN
Middle Name:
Last Name:POTPARIC
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 1:1116 E BROWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306
Mailing Address - Country:US
Mailing Address - Phone:954-779-2777
Mailing Address - Fax:954-779-2177
Practice Address - Street 1:1116 E BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301
Practice Address - Country:US
Practice Address - Phone:954-779-2777
Practice Address - Fax:954-779-2177
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75399174400000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266253100Medicaid
FL46981Medicare ID - Type UnspecifiedPROVIDER NUMBER