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General NPI Number Information
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NPI Number | 1891795258
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Entity Type | Individual
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Provider Name | TANYA B ZIADIE MD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 255 N SYKES CREEK PKWY SUITE 3
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-3518
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Country | US
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Telephone | 321-459-5543
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Fax | 321-455-6537
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Provider Business Mailing Address
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Address Line | 255 N SYKES CREEK PKWY SUITE 3
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-3518
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Country | US
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Telephone | 321-459-5543
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Fax | 321-455-6537
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME77865
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License Number State | FL
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