Healthcare Provider Details

I. General information

NPI: 1255494704
Provider Name (Legal Business Name): YONAS ZEGEYE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HARVARD CIR SUITE 104
WEST PALM BEACH FL
33409-1979
US

IV. Provider business mailing address

5 HARVARD CIR SUITE 104
WEST PALM BEACH FL
33409-1979
US

V. Phone/Fax

Practice location:
  • Phone: 561-603-6652
  • Fax: 888-563-9455
Mailing address:
  • Phone: 561-603-6652
  • Fax: 888-563-9455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME88243
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberME88243
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberME88243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: