MEDICARE: DR. DOMENIC A ZAMBUTO MD

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	202K00000X	Phlebology Physician	ME158436	FL
2	2085R0204X	Vascular & Interventional Radiology Physician	U1791	TX
3	2085R0204X	Vascular & Interventional Radiology Physician	67934	AZ
4	2085R0204X	Vascular & Interventional Radiology Physician	036.126576	IL
5	2085R0204X	Vascular & Interventional Radiology Physician	323885	NY
6	2085R0204X	Vascular & Interventional Radiology Physician	DR.0069421	CO
7	2085R0204X	Vascular & Interventional Radiology Physician	77011	GA
8	2085R0204X	Vascular & Interventional Radiology Physician	25MA09461600	NJ
9	2085R0204X	Vascular & Interventional Radiology Physician	ME158436	FL

General Provider Information

NPI Number	:	1669458766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOMENIC A ZAMBUTO MD

Provider Business Mailing Address
First Line	:	3820 NORTHDALE BLVD STE 201
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1893
Country	:	US
Telephone Number	:	800-991-6117
Fax Number	:	888-812-8191

Provider Business Practice Location Address
First Line	:	3810 NORTHDALE BLVD STE 150
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1871
Country	:	US
Telephone Number	:	813-683-4784
Fax Number	:	888-812-8191

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

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	02/15/2025

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Directions to “ DR. DOMENIC A ZAMBUTO MD” Practice Location

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