Healthcare Provider Details

I. General information

NPI: 1750342457
Provider Name (Legal Business Name): LARA Z ZUBERI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PALM AVE STE 700
JACKSONVILLE FL
32207-8457
US

IV. Provider business mailing address

PO BOX 746654
ATLANTA GA
30374-6654
US

V. Phone/Fax

Practice location:
  • Phone: 904-202-7300
  • Fax: 904-202-2754
Mailing address:
  • Phone: 904-202-2092
  • Fax: 904-376-4075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5929563-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME 110200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: