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General NPI Number Information
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NPI Number | 1457329591
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Entity Type | Individual
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Provider Name | THOMAS ZACHOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1032 MAR WALT DR SUITE 240
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6661
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Country | US
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Telephone | 850-863-0883
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Fax | 850-862-0188
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Provider Business Mailing Address
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Address Line | 4154 BEACH DR
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City | NICEVILLE
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State | FL
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Zip | 32578-2980
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Country | US
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Telephone | 850-376-8739
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Fax |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME38087
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License Number State | FL
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