Healthcare Provider Details

I. General information

NPI: 1922160308
Provider Name (Legal Business Name): SYED I ZAIDI MD FACP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13090 US HIGHWAY 1
SEBASTIAN FL
32958-3733
US

IV. Provider business mailing address

13090 US HIGHWAY 1
SEBASTIAN FL
32958-3733
US

V. Phone/Fax

Practice location:
  • Phone: 772-589-3755
  • Fax: 772-589-2315
Mailing address:
  • Phone: 772-589-3755
  • Fax: 772-589-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0061460
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: