Provider Demographics
NPI:1952497083
Name:KERESZTI, ZSOLT G (MD)
Entity Type:Individual
Prefix:DR
First Name:ZSOLT
Middle Name:G
Last Name:KERESZTI
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 1:8479 S US HIGHWAY 1
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-3360
Mailing Address - Country:US
Mailing Address - Phone:772-344-4644
Mailing Address - Fax:772-344-6066
Practice Address - Street 1:8479 S US HIGHWAY 1
Practice Address - Street 2:SUITE 21
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-3360
Practice Address - Country:US
Practice Address - Phone:772-344-4644
Practice Address - Fax:772-344-6066
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70239225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38026OtherBCBSFL
FL38026AMedicare ID - Type Unspecified
FLG61157Medicare UPIN