Provider Demographics
NPI:1639106578
Name:ZEINI MEDICAL GROUP PA
Entity Type:Organization
Organization Name:ZEINI MEDICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-341-9280
Mailing Address - Street 1:14955 HAWKSMOOR RUN CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7511
Mailing Address - Country:US
Mailing Address - Phone:407-341-9280
Mailing Address - Fax:407-208-0593
Practice Address - Street 1:1817 CRESCENT BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4614
Practice Address - Country:US
Practice Address - Phone:407-341-9280
Practice Address - Fax:407-208-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86118207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1222ZMedicare ID - Type Unspecified
FLH92828Medicare UPIN