Basic Information
| Provider Information | |||||||||
| NPI: | 1942799929 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IVANOFF-TZVETCOFF | ||||||||
| FirstName: | ESTEBAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 NE 109TH ST APT 306 | ||||||||
| Address2: | |||||||||
| City: | NORTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331617321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057331896 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3601 FEDERAL HWY | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331373795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055766611 | ||||||||
| FaxNumber: | 7864762819 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2018 | ||||||||
| LastUpdateDate: | 05/06/2018 | ||||||||
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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 | 207Q00000X | TRN26144 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.