Healthcare Provider Details

I. General information

NPI: 1144234691
Provider Name (Legal Business Name): EGBERTO JOSE ZAYAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MEDICAL PARK DR STE 250
TAMPA FL
33613-4679
US

IV. Provider business mailing address

PO BOX 102222 CREDENTIAL DEPARTMENT
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 813-632-6220
  • Fax: 813-971-5893
Mailing address:
  • Phone: 239-432-8339
  • Fax: 239-278-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME65260
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: