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General NPI Number Information
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NPI Number | 1548061682
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASE DOCTOR
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 400 HEALTHCARE BLVD
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-0400
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Country | US
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Telephone | 904-547-2808
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Fax | 904-679-3169
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Provider Business Mailing Address
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Address Line | 400 MOULTRIE LANDING UNIT 9205
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-6184
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Country | US
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Telephone | 904-547-2808
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Fax | 904-679-3169
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Authorized Official
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Title or Position | OWNER
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Name | MS. DANI ZAVASKY
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Credential | MD
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Telephone | 917-526-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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