Provider Demographics
NPI:1437508561
Name:ZIMKO, ZACHARY (DO)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:ZIMKO
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 1:10225 ULMERTON RD STE 3A
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3519
Mailing Address - Country:US
Mailing Address - Phone:727-371-0079
Mailing Address - Fax:727-371-0079
Practice Address - Street 1:10225 ULMERTON RD STE 3A
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3519
Practice Address - Country:US
Practice Address - Phone:727-371-0079
Practice Address - Fax:727-371-0079
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS151992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105706600Medicaid