Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME65260 | FL |
N | 111NI0900X | Internist | ME65260 | FL |
N | 207RH0000X | Hematologist | ME65260 | FL |
Y | 207RX0202X | Medical Oncology | ME65260 | FL |
NPI | 1144234691 |
---|---|
Provider Name | Dr. Egberto Jose Zayas |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Tampa, FL 33613-4680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 13/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
374050100 | (05) | FL |
C77613 | (02) | FL |
ME0065260 | FLORIDA LICENSE (01) | FL |