Provider Demographics
NPI:1104958602
Name:ZULOVITZ, MARK II (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ZULOVITZ
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1630
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32961-1630
Mailing Address - Country:US
Mailing Address - Phone:772-569-9705
Mailing Address - Fax:
Practice Address - Street 1:951 OLD DIXIE HWY
Practice Address - Street 2:A-1
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4311
Practice Address - Country:US
Practice Address - Phone:772-569-9705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5732111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22281Medicare UPIN