1992861934 NPI number — DR. TAMATHA FRIZZELL ZEMZARS MD

Table of content: DR. TAMATHA FRIZZELL ZEMZARS MD (NPI 1992861934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992861934 NPI number — DR. TAMATHA FRIZZELL ZEMZARS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEMZARS
Provider First Name:
TAMATHA
Provider Middle Name:
FRIZZELL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRIZZELL
Provider Other First Name:
TAMATHA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992861934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4711 34TH ST N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33714-3061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-344-7602
Provider Business Mailing Address Fax Number:
208-765-6075

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4711 34TH ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33714-3061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-344-7602
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  158214 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: M13514 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)