Healthcare Provider Details

I. General information

NPI: 1053870899
Provider Name (Legal Business Name): ROBERT PAUL ZUSMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 TAMIAMI TRL STE 1
PORT CHARLOTTE FL
33948-1018
US

IV. Provider business mailing address

6500 38TH AVE N
ST PETERSBURG FL
33710-1629
US

V. Phone/Fax

Practice location:
  • Phone: 941-629-6262
  • Fax: 941-629-1782
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS20712
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: