MEDICARE: ZANNA OSOKINA REEGT

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	2472E0500X	EEG Technician	7997

General Provider Information

NPI Number	:	1588327811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZANNA OSOKINA REEGT

Provider Business Mailing Address
First Line	:	5340 NW 1ST AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3268
Country	:	US
Telephone Number	:	305-389-6911
Fax Number	:

Provider Business Practice Location Address
First Line	:	5340 NW 1ST AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3268
Country	:	US
Telephone Number	:	305-389-6911
Fax Number	:

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

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	10/13/2021

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