Provider Demographics
NPI:1417938283
Name:ERDOS, ZOLTAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:ZOLTAN
Middle Name:T
Last Name:ERDOS
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 ST
Mailing Address - Street 2:STE 523
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501
Mailing Address - Country:US
Mailing Address - Phone:850-469-0799
Mailing Address - Fax:850-469-0792
Practice Address - Street 1:1717 NORTH E ST
Practice Address - Street 2:STE 523
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501
Practice Address - Country:US
Practice Address - Phone:850-469-0799
Practice Address - Fax:850-469-0792
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2007-09-14
Deactivation Date:2006-05-30
Deactivation Code:
Reactivation Date:2007-09-13
Provider Licenses
StateLicense IDTaxonomies
FLME85316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB938OtherHEALTH FIRST NETWORK
FL0109462OtherUNITED HEALTH CARE
FL51520OtherBCBS OF FLORIDA
AL591-85336OtherBCBS AL
FLP00016992OtherRAILROAD MEDICARE
FLP00016992OtherRAILROAD MEDICARE
FL51520OtherBCBS OF FLORIDA