Provider Demographics
NPI:1518145283
Name:JEFFREY L ZIMM MD PA
Entity Type:Organization
Organization Name:JEFFREY L ZIMM MD PA
Other - Org Name:ALL SAINTS EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-592-5511
Mailing Address - Street 1:1435 IMMOKALEE RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1401
Mailing Address - Country:US
Mailing Address - Phone:239-592-5511
Mailing Address - Fax:239-592-9259
Practice Address - Street 1:1435 IMMOKALEE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1401
Practice Address - Country:US
Practice Address - Phone:239-592-5511
Practice Address - Fax:239-592-9259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057862174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL410043287OtherRAILROAD MEDICARE
FL34979OtherBCBS
FL3896340001Medicare PIN
FLK1397Medicare PIN
FL3896340001Medicare NSC