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General NPI Number Information
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NPI Number | 1073588604
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Entity Type | Individual
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Provider Name | NEIL BRYAN ZUSMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 3430 TAMIAMI TRL SUITE A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8127
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Country | US
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Telephone | 941-624-4500
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Fax | 941-624-6066
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Provider Business Mailing Address
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Address Line | PO BOX 495658
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-5658
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Country | US
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Telephone | 941-624-4500
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Fax | 941-624-6066
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME53134
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License Number State | FL
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