Healthcare Provider Details

I. General information

NPI: 1902256027
Provider Name (Legal Business Name): ZALIKA NISBETH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 01/06/2025
Certification Date: 01/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 COMMERCIAL DR STE C8
SAVANNAH GA
31406-3633
US

IV. Provider business mailing address

86 SAN BRISO WAY
SAINT AUGUSTINE FL
32092-3115
US

V. Phone/Fax

Practice location:
  • Phone: 904-833-8325
  • Fax: 904-585-7341
Mailing address:
  • Phone: 904-833-8325
  • Fax: 904-585-7341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number85501
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME135573
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number85501
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME135573
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: