Provider Demographics
NPI:1528008190
Name:HTAY, ZAW (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAW
Middle Name:
Last Name:HTAY
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 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-361-5581
Mailing Address - Fax:
Practice Address - Street 1:1350 HICKORY ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3224
Practice Address - Country:US
Practice Address - Phone:321-361-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70320208M00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022006200Medicaid
FLSB843OtherMEDICARE HF
FL41849OtherBCBS OF FL
FL1068074OtherCAREPLUS HEALTH PLAN
FL277748700Medicaid
FLPRO6510OtherQUALITY HEALTH PLAN
FL01131747OtherAMERIGROUP
FLP00846410OtherMEDICARE RAILROAD
FL277748700Medicaid
FL01131747OtherAMERIGROUP