Provider Demographics
NPI:1104366277
Name:MILANO, ZACHARY (DO)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:MILANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4541 S DALE MABRY HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-1407
Mailing Address - Country:US
Mailing Address - Phone:813-533-7030
Mailing Address - Fax:813-605-6059
Practice Address - Street 1:4541 S DALE MABRY HWY STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-1407
Practice Address - Country:US
Practice Address - Phone:813-533-7030
Practice Address - Fax:813-605-6059
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17052207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program