Healthcare Provider Details

I. General information

NPI: 1316872666
Provider Name (Legal Business Name): MRS. MEGHAN REGINA ZOLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 CATTLEMEN RD
SARASOTA FL
34232-6243
US

IV. Provider business mailing address

14007 CRIMSON AVE
LAKEWOOD RANCH FL
34211-1643
US

V. Phone/Fax

Practice location:
  • Phone: 941-697-3001
  • Fax:
Mailing address:
  • Phone: 631-889-2097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11048308
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: