MEDICARE: SUZAN E ZIMMER DO

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	207Q00000X	Family Medicine Physician	OS6842	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00053450	OTHER	FL	RAILROAD MEDICARE
4	57154X	OTHER	FL	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2973824001	OTHER	FL	CIGNA
2	281329	OTHER	FL	WELLCARE
5	7380593	OTHER	FL	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	57154	OTHER	FL	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750351151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZAN E ZIMMER DO

Provider Business Mailing Address
First Line	:	3255 S US HIGHWAY 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6381
Country	:	US
Telephone Number	:	772-742-9270
Fax Number	:	772-742-9278

Provider Business Practice Location Address
First Line	:	3255 S US HIGHWAY 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6381
Country	:	US
Telephone Number	:	772-742-9270
Fax Number	:	772-742-9278

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	03/17/2018

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Directions to “ SUZAN E ZIMMER DO” Practice Location

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