Provider Demographics
NPI:1386961167
Name:DZIK, JUSTIN NOEL (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:NOEL
Last Name:DZIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14050 NW 14TH ST
Mailing Address - Street 2:SUITE 190
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2865
Mailing Address - Country:US
Mailing Address - Phone:954-377-2917
Mailing Address - Fax:954-424-3270
Practice Address - Street 1:14050 NW 14TH ST
Practice Address - Street 2:SUITE 190
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2865
Practice Address - Country:US
Practice Address - Phone:954-377-2917
Practice Address - Fax:954-424-3270
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114893207P00000X
AZ63050207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine