Provider Demographics
NPI:1588674253
Name:ZEOLI, KATHRYN (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:ZEOLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6136
Mailing Address - Country:US
Mailing Address - Phone:954-436-5625
Mailing Address - Fax:954-436-0115
Practice Address - Street 1:10001 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6136
Practice Address - Country:US
Practice Address - Phone:954-436-5625
Practice Address - Fax:954-678-3989
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036826174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0970Medicare UPIN
FLD77098Medicare UPIN