Provider Demographics
NPI:1033167663
Name:ZEREGA, JOSEPH JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JOHN
Last Name:ZEREGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 11TH CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4837
Mailing Address - Country:US
Mailing Address - Phone:772-299-3511
Mailing Address - Fax:772-299-3517
Practice Address - Street 1:3745 11TH CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4837
Practice Address - Country:US
Practice Address - Phone:772-299-3511
Practice Address - Fax:772-299-3517
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78827207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100015009OtherRR MEDICARE
FL49458OtherBLUE CROSS
FL259754300Medicaid
FL259754300Medicaid
FLE02751Medicare UPIN