Healthcare Provider Details

I. General information

NPI: 1447664453
Provider Name (Legal Business Name): PETER JAMES ZAVITSANOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 06/14/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15211 CORTEZ BLVD
BROOKSVILLE FL
34613-6072
US

IV. Provider business mailing address

14690 SPRING HILL DR STE 305
SPRING HILL FL
34609-8102
US

V. Phone/Fax

Practice location:
  • Phone: 352-345-4565
  • Fax: 352-596-6051
Mailing address:
  • Phone: 352-277-5348
  • Fax: 352-606-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME138420
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: