Healthcare Provider Details

I. General information

NPI: 1710909213
Provider Name (Legal Business Name): DONALD J ZELLER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 SARANAC RD
SEA RANCH LAKES FL
33308-2911
US

IV. Provider business mailing address

24 SARANAC RD
SEA RANCH LAKES FL
33308-2911
US

V. Phone/Fax

Practice location:
  • Phone: 954-683-1304
  • Fax:
Mailing address:
  • Phone: 954-683-1304
  • Fax: 954-967-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD J ZELLER
Title or Position: OWNER
Credential: M.D.
Phone: 954-683-1304