Healthcare Provider Details

I. General information

NPI: 1639106578
Provider Name (Legal Business Name): ZEINI MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 CRESCENT BLVD
ORLANDO FL
32817-4614
US

IV. Provider business mailing address

14955 HAWKSMOOR RUN CIR
ORLANDO FL
32828-7511
US

V. Phone/Fax

Practice location:
  • Phone: 407-341-9280
  • Fax: 407-208-0593
Mailing address:
  • Phone: 407-341-9280
  • Fax: 407-208-0593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberME86118
License Number StateFL

VIII. Authorized Official

Name: DR. MINA ZEINI
Title or Position: PRESIDENT
Credential: M.D
Phone: 407-341-9280