Provider Demographics
NPI:1356322192
Name:ZEBROWSKI, BRIAN K (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:ZEBROWSKI
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 1:3810 NORTHDALE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1871
Mailing Address - Country:US
Mailing Address - Phone:813-961-1331
Mailing Address - Fax:888-850-8316
Practice Address - Street 1:655 S DOBSON RD STE 216
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5671
Practice Address - Country:US
Practice Address - Phone:800-991-6117
Practice Address - Fax:888-812-8191
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97075208600000X
AZ35955208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL146VGOtherBCBS
FL001721600OtherMEDICAID
AZ164561OtherHEALTH CHOICE AZ
AZ2Z4645OtherHEALTH NET OF AZ
AZAZ0928750OtherBCBS
AZ164561001OtherARIZONA PHYSICIANS IPA
NY02572916Medicaid
AZ164561Medicaid
AZZ112113Medicare PIN
FL146VGOtherBCBS
FLCY189ZMedicare PIN
FLCY189YMedicare PIN