MEDICARE: DONALD J ZELLER MD PA

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number	:	1710909213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD J ZELLER MD PA

Provider Business Mailing Address
First Line	:	24 SARANAC RD
Second Line	:
City	:	SEA RANCH LAKES
State	:	FL
Zip	:	33308-2911
Country	:	US
Telephone Number	:	954-683-1304
Fax Number	:	954-967-0109

Provider Business Practice Location Address
First Line	:	24 SARANAC RD
Second Line	:
City	:	SEA RANCH LAKES
State	:	FL
Zip	:	33308-2911
Country	:	US
Telephone Number	:	954-683-1304
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DONALD J ZELLER
Credential	:	M.D.
Telephone Number	:	954-683-1304

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	10/20/2009

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