Healthcare Provider Details

I. General information

NPI: 1487571998
Provider Name (Legal Business Name): OMAR ZEIDAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CELEBRATION PL
CELEBRATION FL
34747-4606
US

IV. Provider business mailing address

380 CELEBRATION PL
CELEBRATION FL
34747-4606
US

V. Phone/Fax

Practice location:
  • Phone: 407-235-0269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License NumberTRP276
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: