MEDICARE: DANIEL J. ZALUZEC MDPA

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	207Y00000X	Otolaryngology Physician	ME86921	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
2	71787	OTHER	FL	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1174830558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL J. ZALUZEC MDPA

Provider Business Mailing Address
First Line	:	101 NE CHARLESTON OAKS DR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-3345
Country	:	US
Telephone Number	:	772-343-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 NE CHARLESTON OAKS DR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-3345
Country	:	US
Telephone Number	:	772-343-0000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL JOHN ZALUZEC
Credential	:	M.D.
Telephone Number	:	772-342-6647

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	09/08/2010

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