Provider Demographics
NPI:1740289404
Name:ZUZGA, MARK ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDREW
Last Name:ZUZGA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1840 MEASE DRIVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6605
Mailing Address - Country:US
Mailing Address - Phone:727-712-3233
Mailing Address - Fax:727-712-1853
Practice Address - Street 1:1840 MEASE DRIVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6605
Practice Address - Country:US
Practice Address - Phone:727-712-3233
Practice Address - Fax:727-712-1853
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9474174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5106ZMedicare PIN
FLI34998Medicare UPIN