Healthcare Provider Details

I. General information

NPI: 1417310020
Provider Name (Legal Business Name): ALEXANDRA ZAVIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13340 METRO PKWY STE 400
FORT MYERS FL
33966-4818
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-1105
  • Fax: 239-343-1106
Mailing address:
  • Phone: 393-431-1052
  • Fax: 239-343-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS18964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: