Provider Demographics
NPI:1235355397
Name:ZEIDAN, FADY D (MD)
Entity Type:Individual
Prefix:DR
First Name:FADY
Middle Name:D
Last Name:ZEIDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10441 QUALITY DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-9656
Mailing Address - Country:US
Mailing Address - Phone:352-686-6114
Mailing Address - Fax:352-686-0796
Practice Address - Street 1:10441 QUALITY DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-9656
Practice Address - Country:US
Practice Address - Phone:352-686-6114
Practice Address - Fax:352-686-0796
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062904207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377263200Medicaid
FLF54139Medicare UPIN
FL18682YMedicare PIN