MEDICARE: THE CLINIC OF PEDIATRICS & GI MEDICINE, INC.

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	2080P0206X	Pediatric Gastroenterology Physician
2	208000000X	Pediatrics Physician

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	:	1326159310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CLINIC OF PEDIATRICS & GI MEDICINE, INC.

Provider Business Mailing Address
First Line	:	102 MEDICAL CENTER DR
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4907
Country	:	US
Telephone Number	:	850-913-1666
Fax Number	:	850-913-1549

Provider Business Practice Location Address
First Line	:	102 MEDICAL CENTER DR
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4907
Country	:	US
Telephone Number	:	850-913-1666
Fax Number	:	850-913-1549

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMMED M ZEINOMAR
Credential	:	MD
Telephone Number	:	850-913-1666

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	01/29/2025

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Directions to “THE CLINIC OF PEDIATRICS & GI MEDICINE, INC. ” Practice Location

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