=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851888259
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ZHENISA HYSENAJ MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2018
-----------------------------------------------------
Last Update Date | 11/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 658 OVIEDO MEDICAL DR
-----------------------------------------------------
City | OVIEDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32765-6574
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-901-9076
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 658 OVIEDO MEDICAL DR
-----------------------------------------------------
City | OVIEDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32765-6574
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-901-9076
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | ME0168378
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------