Provider Demographics
NPI:1992392062
Name:ORR, ZACHARY MICHAEL (PA-C)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:MICHAEL
Last Name:ORR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 N E ST STE 331
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6335
Mailing Address - Country:US
Mailing Address - Phone:850-444-1772
Mailing Address - Fax:850-444-1755
Practice Address - Street 1:1717 N E ST STE 331
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6335
Practice Address - Country:US
Practice Address - Phone:850-484-6500
Practice Address - Fax:850-444-1755
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1174465363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174465OtherNCCPA
FLNO182OtherMEDICARE - FL