Provider Demographics
NPI:1467905232
Name:KAZDAN, MARCIE (PA-C)
Entity type:Individual
Prefix:
First Name:MARCIE
Middle Name:
Last Name:KAZDAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9960 NW 116TH WAY STE 13
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1175
Mailing Address - Country:US
Mailing Address - Phone:786-924-1311
Mailing Address - Fax:786-924-1313
Practice Address - Street 1:9970 CENTRAL PARK BLVD N STE 207
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2236
Practice Address - Country:US
Practice Address - Phone:561-482-1027
Practice Address - Fax:561-482-1028
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2024-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY019721-1363AM0700X
FL9116683363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical