Provider Demographics
NPI:1336158765
Name:CLAUDIA A DRAIZIN DMD PA
Entity type:Organization
Organization Name:CLAUDIA A DRAIZIN DMD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DRAIZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-647-6014
Mailing Address - Street 1:11715 STRAND WAY
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3710
Mailing Address - Country:US
Mailing Address - Phone:954-431-4433
Mailing Address - Fax:954-430-9966
Practice Address - Street 1:11715 STRAND WAY
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-3710
Practice Address - Country:US
Practice Address - Phone:954-647-6014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty