Provider Demographics
NPI:1023443314
Name:EL-DAGHAR, ZINA SAMEH (PA)
Entity type:Individual
Prefix:
First Name:ZINA
Middle Name:SAMEH
Last Name:EL-DAGHAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:ZINA
Other - Middle Name:
Other - Last Name:EL-DAGHAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:1250 NW 21ST ST APT 1006
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-7734
Mailing Address - Country:US
Mailing Address - Phone:561-713-3116
Mailing Address - Fax:
Practice Address - Street 1:1190 NW 95TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2064
Practice Address - Country:US
Practice Address - Phone:305-691-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107428363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant