MEDICARE: LAURENCE ZEITLIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	ME37456	FL

General Provider Information

NPI Number	:	1093763229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURENCE ZEITLIN M.D.

Provider Business Mailing Address
First Line	:	3001 EXECUTIVE DR STE 130
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33762-5323
Country	:	US
Telephone Number	:	727-347-0005
Fax Number	:	727-541-6558

Provider Business Practice Location Address
First Line	:	33920 US HIGHWAY 19 N
Second Line	:	SUITE 124
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-2654
Country	:	US
Telephone Number	:	727-785-7654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	03/16/2018

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