Provider Demographics
NPI:1194787812
Name:CZINN, EDWARD A (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:CZINN
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 1:2964 N STATE ROAD 7
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5715
Mailing Address - Country:US
Mailing Address - Phone:954-580-8838
Mailing Address - Fax:954-580-8839
Practice Address - Street 1:2964 N STATE ROAD 7
Practice Address - Street 2:SUITE 206
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5715
Practice Address - Country:US
Practice Address - Phone:954-580-8838
Practice Address - Fax:954-580-8839
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67999207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252649200Medicaid
FL31887ZMedicare ID - Type Unspecified
FL252649200Medicaid