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General NPI Number Information
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NPI Number | 1144244625
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Entity Type | Individual
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Provider Name | ZIA FATEMI MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 758 N SUN DR SUITE #104
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City | LAKE MARY
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State | FL
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Zip | 32746-2599
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Country | US
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Telephone | 407-333-3303
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Fax | 407-333-3342
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Provider Business Mailing Address
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Address Line | 758 N SUN DR SUITE #104
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City | LAKE MARY
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State | FL
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Zip | 32746-2599
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Country | US
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Telephone | 407-333-3303
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Fax | 407-333-3342
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0074891
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License Number State | FL
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