Healthcare Provider Details

I. General information

NPI: 1477540722
Provider Name (Legal Business Name): ZACHARIAS C. MIKRONIS PAAA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

3155 N POINT PKWY
ALPHARETTA GA
30005-5481
US

V. Phone/Fax

Practice location:
  • Phone: 678-216-0771
  • Fax:
Mailing address:
  • Phone: 770-645-9181
  • Fax: 770-645-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number3186
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAA464
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: