Provider Demographics
NPI:1073588604
Name:ZUSMAN, NEIL BRYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:BRYAN
Last Name:ZUSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 495658
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-5658
Mailing Address - Country:US
Mailing Address - Phone:941-624-4500
Mailing Address - Fax:941-624-6066
Practice Address - Street 1:3430 TAMIAMI TRL
Practice Address - Street 2:SUITE A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8127
Practice Address - Country:US
Practice Address - Phone:941-624-4500
Practice Address - Fax:941-624-6066
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME53134207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180035780OtherRR MEDICARE
FL051561200Medicaid
FL05970BMedicare PIN
FLD21078Medicare UPIN