Individual
JAN IZAKOVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1475 NW 12TH AVE, MIAMI, FL 33136-1002
(305) 243-8693
Mailing address
1475 NW 12TH AVE, MIAMI, FL 33136-1002
(305) 243-8693
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MFC1665
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0027148-00
—
FL
Enumeration date
08/20/2010
Last updated
11/18/2011
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