Basic Information
Provider Information
NPI: 1609386655
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MATHEWS
FirstName: ZUBIN
MiddleName: JOSEPH
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 901 COLONY POINT CIR
Address2:  
City: PEMBROKE PINES
State: FL
PostalCode: 330262936
CountryCode: US
TelephoneNumber: 9419792033
FaxNumber:  
Practice Location
Address1: 3100 SW 62ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331553009
CountryCode: US
TelephoneNumber: 3056666511
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/04/2017
LastUpdateDate: 10/04/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X FLY Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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