Healthcare Provider Details

I. General information

NPI: 1518145283
Provider Name (Legal Business Name): JEFFREY L ZIMM MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 IMMOKALEE RD
NAPLES FL
34110-1401
US

IV. Provider business mailing address

1435 IMMOKALEE RD
NAPLES FL
34110-1401
US

V. Phone/Fax

Practice location:
  • Phone: 239-592-5511
  • Fax: 239-592-9259
Mailing address:
  • Phone: 239-592-5511
  • Fax: 239-592-9259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY L ZIMM
Title or Position: MD / AUTHORIZED OFFICIAL
Credential:
Phone: 239-592-5511