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General NPI Number Information
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NPI Number | 1265704530
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Entity Type | Organization
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Legal Business Name | PAUL D. ZAWATSKY, MD, PA
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 11481 OLD SAINT AUGUSTINE RD STE 103
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1474
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Country | US
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Telephone | 904-260-8424
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Fax | 904-341-4777
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Provider Business Mailing Address
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Address Line | 3631 MOSSWOOD CT
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City | JACKSONVILLE
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State | FL
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Zip | 32223-3255
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL D. ZAWATSKY
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Credential | MD
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Telephone | 904-260-8424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME63004
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License Number State | FL
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