Provider Demographics
NPI:1083082721
Name:ZAYDON, SAMUEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JOSEPH
Last Name:ZAYDON
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:PO BOX 511151
Mailing Address - Street 2:
Mailing Address - City:KEY COLONY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33051-1151
Mailing Address - Country:US
Mailing Address - Phone:786-269-7777
Mailing Address - Fax:
Practice Address - Street 1:18141 SW 89TH AVE
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5978
Practice Address - Country:US
Practice Address - Phone:786-269-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042525207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine