Provider Demographics
NPI:1558354316
Name:ZYLIS, ROBERT (ARNP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ZYLIS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 773176
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34477-3176
Mailing Address - Country:US
Mailing Address - Phone:352-873-3800
Mailing Address - Fax:352-873-4800
Practice Address - Street 1:4460 SW 20TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0163
Practice Address - Country:US
Practice Address - Phone:352-873-3800
Practice Address - Fax:352-873-4800
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3064782363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304593500Medicaid
FLE5059WMedicare PIN
FL304593500Medicaid