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General NPI Number Information
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NPI Number | 1972928984
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Entity Type | Organization
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Legal Business Name | SUZAN E ZIMMER, D.O., PA
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 2100 NEBRASKA AVE SUITE 111
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City | FORT PIERCE
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State | FL
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Zip | 34950-4704
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Country | US
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Telephone | 772-519-1765
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 NEBRASKA AVE SUITE 111
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City | FORT PIERCE
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State | FL
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Zip | 34950-4704
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Country | US
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Telephone | 772-519-1765
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. SUZAN E ZIMMER
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Credential | DO
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Telephone | 772-519-1765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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