Healthcare Provider Details

I. General information

NPI: 1245297977
Provider Name (Legal Business Name): JAMES P ZAVITSANOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N WICKHAM RD STE 202
MELBOURNE FL
32935-8660
US

IV. Provider business mailing address

240 N WICKHAM RD STE 202
MELBOURNE FL
32935-8660
US

V. Phone/Fax

Practice location:
  • Phone: 321-541-1746
  • Fax: 321-676-2613
Mailing address:
  • Phone: 321-541-1746
  • Fax: 321-676-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME53132
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: