Provider Demographics
NPI:1932499431
Name:ZASADA, KEVIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:ZASADA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4407
Mailing Address - Country:US
Mailing Address - Phone:407-343-4983
Mailing Address - Fax:407-343-4705
Practice Address - Street 1:1205 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4407
Practice Address - Country:US
Practice Address - Phone:407-343-4983
Practice Address - Fax:407-343-4705
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP03479213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO3479OtherLISENCE
FLFZ2528719OtherDEA