Provider Demographics
NPI:1003857558
Name:ZOLTAN T ERDOS, MD PA
Entity Type:Organization
Organization Name:ZOLTAN T ERDOS, MD PA
Other - Org Name:ZOLTAN T ERDOS, MD PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:H
Authorized Official - Last Name:BILBREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-469-0799
Mailing Address - Street 1:1717 NORTH E ST
Mailing Address - Street 2:STE 523
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501
Mailing Address - Country:US
Mailing Address - Phone:850-469-0799
Mailing Address - Fax:850-469-0792
Practice Address - Street 1:1717 NORTH E ST
Practice Address - Street 2:STE 523
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501
Practice Address - Country:US
Practice Address - Phone:850-469-0799
Practice Address - Fax:850-469-0792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0093Medicare PIN