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General NPI Number Information
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NPI Number | 1346293255
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Entity Type | Individual
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Provider Name | ELISA A ZENNI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 515 WEST 6TH STREET
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City | JACKSONVILLE
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State | FL
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Zip | 32206
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Country | US
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Telephone | 904-253-1080
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Fax | 904-253-1953
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Provider Business Mailing Address
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Address Line | PO BOX 44008
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City | JACKSONVILLE
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State | FL
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Zip | 32231-4008
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Country | US
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Telephone | 904-633-0355
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Fax | 904-383-1413
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME68619
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License Number State | FL
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