Provider Demographics
NPI:1093975013
Name:GORDON H. ZUERNDORFER M.D., P.A.
Entity Type:Organization
Organization Name:GORDON H. ZUERNDORFER M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZUERNDORFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-724-6300
Mailing Address - Street 1:1831 N BELCHER RD
Mailing Address - Street 2:STE G-1
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1449
Mailing Address - Country:US
Mailing Address - Phone:727-724-6300
Mailing Address - Fax:727-724-6330
Practice Address - Street 1:1831 N BELCHER RD
Practice Address - Street 2:STE G-1
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1449
Practice Address - Country:US
Practice Address - Phone:727-724-6300
Practice Address - Fax:727-724-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55438207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09149AMedicare UPIN