Basic Information
| Provider Information | |||||||||
| NPI: | 1770784431 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAVOYSKI | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 NW 64TH ST | ||||||||
| Address2: | SUITE 700 | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333091800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545804084 | ||||||||
| FaxNumber: | 9545305096 | ||||||||
| Practice Location | |||||||||
| Address1: | 2964 N STATE ROAD 7 | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | MARGATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330635715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545804080 | ||||||||
| FaxNumber: | 9545804081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 01/20/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TRN8665 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207X00000X | ME106992 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 148PD | 01 | FL | BCBSFL | OTHER | 2293600 | 05 | FL | MEDICAID |