MEDICARE: MR. KEVIN JOHN ZIEGLER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA-001195-L	PA
2	363A00000X	Physician Assistant	PA9109340	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023129806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEVIN JOHN ZIEGLER PA-C

Provider Business Mailing Address
First Line	:	PO BOX 102222
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-2222
Country	:	US
Telephone Number	:	239-432-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3730 7TH TER STE 101
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-6556
Country	:	US
Telephone Number	:	772-567-2332
Fax Number	:	844-812-2806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/19/2023

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