Provider Demographics
NPI:1699817650
Name:ZIMMERN, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ZIMMERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2896 GULF BREEZE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3146
Mailing Address - Country:US
Mailing Address - Phone:850-932-2203
Mailing Address - Fax:
Practice Address - Street 1:2896 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3146
Practice Address - Country:US
Practice Address - Phone:850-932-2203
Practice Address - Fax:850-934-0050
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0030936207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080092452OtherRAILROAD MEDICARE
FL080092452OtherRAILROAD MEDICARE