Healthcare Provider Details

I. General information

NPI: 1558170662
Provider Name (Legal Business Name): ZIZ MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W BAY DR STE 321
LARGO FL
33770
US

IV. Provider business mailing address

4604 49TH ST N
ST PETERSBURG FL
33709-3842
US

V. Phone/Fax

Practice location:
  • Phone: 727-858-5508
  • Fax:
Mailing address:
  • Phone: 727-858-5508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SYED MUSTAFA ZAIDI
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 727-858-5508