Provider Demographics
NPI:1285812511
Name:SCOTT D KAZDAN DO PA
Entity type:Organization
Organization Name:SCOTT D KAZDAN DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAZDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-442-7616
Mailing Address - Street 1:PO BOX 266828
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33328
Mailing Address - Country:US
Mailing Address - Phone:954-442-7616
Mailing Address - Fax:954-442-6234
Practice Address - Street 1:601 N FLAMINGO ROAD
Practice Address - Street 2:SUITE 209
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-442-7616
Practice Address - Fax:954-442-6234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0006354207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty