Healthcare Provider Details

I. General information

NPI: 1154903854
Provider Name (Legal Business Name): ALI ZAIDI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15141 OGDEN LOOP
ODESSA FL
33556-4633
US

IV. Provider business mailing address

15141 OGDEN LOOP
ODESSA FL
33556-4633
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-1186
  • Fax: 844-691-5928
Mailing address:
  • Phone: 813-333-1186
  • Fax: 844-691-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberOS22346
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: