Healthcare Provider Details

I. General information

NPI: 1245507250
Provider Name (Legal Business Name): THOMAS L. ZOELLER, MD,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2011
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 SE 17TH ST STE 102
OCALA FL
34471-5550
US

IV. Provider business mailing address

2760 SE 17TH ST STE 102
OCALA FL
34471-5550
US

V. Phone/Fax

Practice location:
  • Phone: 352-629-0028
  • Fax: 352-629-1512
Mailing address:
  • Phone: 352-629-0028
  • Fax: 352-629-1512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS L. ZOELLER
Title or Position: PRESIDENT OF CORPORATION
Credential: M.D.
Phone: 352-629-0028