Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME0054576 | FL |
NPI | 1083625420 |
---|---|
Provider Name | Dr. Paul J Zak |
First Address | Clearwater, FL 33764 |
Second Address | Clearwater, FL 33764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 12/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E88423 | (02) | FL |