Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME67849 | FL |
N | 207VG0400X | Gynecologist | ME67849 | FL |
NPI | 1003807082 |
---|---|
Provider Name | Dr. Gregory A. Zittel |
First Address | Lake Mary, FL 32746-5716 |
Second Address | Lake Mary, FL 32746-5716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 05/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
379946800 | (05) | FL |
G11792 | (02) |