Healthcare Provider Details

I. General information

NPI: 1023008489
Provider Name (Legal Business Name): PATRICK ZIEMANN-GIMMEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WHETSTONE PL
ST AUGUSTINE FL
32086-5774
US

IV. Provider business mailing address

108 TRADESMAN LN
SAINT JOHNS FL
32259-8538
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-4478
  • Fax:
Mailing address:
  • Phone: 904-819-4478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number99902
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number100393
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: