Provider Demographics
NPI:1699490292
Name:LEONARDO ZAYAS-BAZAN DPM LLC
Entity type:Organization
Organization Name:LEONARDO ZAYAS-BAZAN DPM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEONARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAYAS-BAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-564-3810
Mailing Address - Street 1:9035 SUNSET DR STE 200B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3451
Mailing Address - Country:US
Mailing Address - Phone:305-564-3810
Mailing Address - Fax:305-686-9884
Practice Address - Street 1:9035 SUNSET DR STE 200B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3451
Practice Address - Country:US
Practice Address - Phone:305-564-3810
Practice Address - Fax:305-686-9884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty