Healthcare Provider Details

I. General information

NPI: 1447348750
Provider Name (Legal Business Name): DENNIZ ASAD ZOLNOUN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 60TH STREET CT W
BRADENTON FL
34209-6609
US

IV. Provider business mailing address

2310 60TH STREET CT W
BRADENTON FL
34209-6609
US

V. Phone/Fax

Practice location:
  • Phone: 941-792-4993
  • Fax: 941-795-2905
Mailing address:
  • Phone: 941-792-4993
  • Fax: 941-795-2905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number9901089
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME130636
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: