MEDICARE: MINA B ZAHEDI MD

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	207R00000X	Internal Medicine Physician	ME79263	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110231155	OTHER	FL	MEDICARE RAILROAD
3	K2990	OTHER	FL	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	03248	OTHER	FL	BCBS OF FLORIDA

General Provider Information

NPI Number	:	1982666814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINA B ZAHEDI MD

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 400
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2051
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 S NOVA RD STE 4&5
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-0410
Country	:	US
Telephone Number	:	386-615-8122
Fax Number	:	844-899-3686

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	02/23/2024

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Directions to “ MINA B ZAHEDI MD” Practice Location

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