MEDICARE: NICOLAS G ZOUAIN 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	2085R0001X	Radiation Oncology Physician	ME104239	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P116159	OTHER	FL	FREEDOM HEALTH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861413106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLAS G ZOUAIN MD

Provider Business Mailing Address
First Line	:	12109 COUNTY ROAD 103
Second Line	:
City	:	OXFORD
State	:	FL
Zip	:	34484-2951
Country	:	US
Telephone Number	:	352-205-8981
Fax Number	:

Provider Business Practice Location Address
First Line	:	2560 ENTERPRISE RD E
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-1010
Country	:	US
Telephone Number	:	727-796-5354
Fax Number	:

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

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	06/07/2021

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