Healthcare Provider Details

I. General information

NPI: 1497678031
Provider Name (Legal Business Name): ZAINA OTHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 MANATEE AVE W STE 101
BRADENTON FL
34209-2303
US

IV. Provider business mailing address

8018 FAWNRIDGE CIR
TAMPA FL
33610-9584
US

V. Phone/Fax

Practice location:
  • Phone: 194-121-6293
  • Fax:
Mailing address:
  • Phone: 813-468-5982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: