Healthcare Provider Details

I. General information

NPI: 1902193782
Provider Name (Legal Business Name): RYAN MICHAEL ZALESKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3007 MANATEE AVE W
BRADENTON FL
34205-4240
US

IV. Provider business mailing address

3007 MANATEE AVE W
BRADENTON FL
34205-4240
US

V. Phone/Fax

Practice location:
  • Phone: 941-748-8069
  • Fax: 941-748-6609
Mailing address:
  • Phone: 941-748-8069
  • Fax: 941-748-6609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0102203202
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0102203202
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS16842
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: