Healthcare Provider Details

I. General information

NPI: 1982151734
Provider Name (Legal Business Name): LAUREN BOWEN ZIRGIBEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2452 MAHAN DR
TALLAHASSEE FL
32308-5373
US

IV. Provider business mailing address

2452 MAHAN DR
TALLAHASSEE FL
32308-5373
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-2126
  • Fax:
Mailing address:
  • Phone: 850-877-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9110453
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA8099
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberPA9110453
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: