Healthcare Provider Details

I. General information

NPI: 1215910245
Provider Name (Legal Business Name): TODD LEWIS ZIMMERMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 SOUTHERN BLVD
LOXAHATCHEE FL
33470-9203
US

IV. Provider business mailing address

964 SE ATLANTIC DR
LANTANA FL
33462-4704
US

V. Phone/Fax

Practice location:
  • Phone: 561-798-3300
  • Fax:
Mailing address:
  • Phone: 561-222-7396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036097110
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberOS8330
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO2300
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberDO2300
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: