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NPI Code Detail

MEDICARE: JONATHAN RYAN ZEITZER DO

MEDICARE: JONATHAN RYAN ZEITZER DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine PhysicianOS23828FL

General Provider Information

NPI Number : 1043912736
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN RYAN ZEITZER DO
Provider Business Mailing Address
First Line : 2001 KINGSLEY AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-5148
Country : US
Telephone Number : 904-639-2003
Fax Number :
Provider Business Practice Location Address
First Line : 2001 KINGSLEY AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-5148
Country : US
Telephone Number : 904-639-2003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2023
Last Update Date : 06/11/2026

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