Individual provider Active NPI

Anthony Zollicoffer

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Aventura, FL
National Provider Identifier
1912557380
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
L18000008041 Issued in FL
Practice address
17971 Biscayne Blvd Ste 102
Aventura, FL 33160-2531
Phone
(786) 524-1040
NPI assigned
Sep 17, 2019
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X L18000008041 FL Primary

Addresses

Primary practice location

17971 Biscayne Blvd Ste 102
Aventura, FL 33160-2531

Mailing address

17971 Biscayne Blvd Ste 102
Aventura, FL 33160-2531
Phone (786) 524-1040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L18000008041FLMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic #2 LLC Sleep Medicine CurrentSince Sep 25, 2019 Accepting new patients

Locations

17971 Biscayne Blvd
Ste 102
Aventura, FL 33160
Phone (786) 524-1040

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1912557380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17971 BISCAYNE BLVD STE 102",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331602531",
            "telephone_number": "786-524-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17971 BISCAYNE BLVD STE 102",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331602531",
            "telephone_number": "786-524-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLICOFFER",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-17",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "FL",
            "license": "L18000008041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.