Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | ME118157 | FL |
N | 2086S0127X | Trauma Surgeon | ME118167 | FL |
NPI | 1316287345 |
---|---|
Provider Name | Scott Zenoni |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2013 |
Last Update Date | 13/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100099700 | (05) | FL |
JK683Y | MEDICARE (01) | FL |
JK683Z | MEDICARE (01) | FL |