Provider Demographics
NPI:1306867197
Name:ZHANG, MING MING (MD)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:MING
Last Name:ZHANG
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 1:1717 NORTH E STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6336
Mailing Address - Country:US
Mailing Address - Phone:850-434-1863
Mailing Address - Fax:850-432-9090
Practice Address - Street 1:1717 NORTH E STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6336
Practice Address - Country:US
Practice Address - Phone:850-434-1863
Practice Address - Fax:850-432-9090
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94671208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274502000Medicaid
FL37400OtherFLORIDA BLUE
FL274502000Medicaid
FLU7070ZMedicare PIN
FLP00288507OtherRRB PTAN