Provider Demographics
NPI:1629116041
Name:TZEEL, EYAL ALBERT (MD)
Entity Type:Individual
Prefix:
First Name:EYAL
Middle Name:ALBERT
Last Name:TZEEL
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 1:15319 WIND WHISPER DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1794
Mailing Address - Country:US
Mailing Address - Phone:262-825-8294
Mailing Address - Fax:920-632-1401
Practice Address - Street 1:4030 W BOY SCOUT BLVD FL 10
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5713
Practice Address - Country:US
Practice Address - Phone:262-825-8294
Practice Address - Fax:920-632-1401
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0119137208000000X
MI4301407222208000000X
WI40918-20208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F70285Medicare UPIN