Provider Demographics
NPI:1134167000
Name:VYAS, ZABUNISSA (MD)
Entity type:Individual
Prefix:DR
First Name:ZABUNISSA
Middle Name:
Last Name:VYAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10051 5TH ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2289
Mailing Address - Country:US
Mailing Address - Phone:407-788-6399
Mailing Address - Fax:407-788-0404
Practice Address - Street 1:320 W SABAL PALM PL
Practice Address - Street 2:SUITE 200
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3639
Practice Address - Country:US
Practice Address - Phone:407-788-6399
Practice Address - Fax:407-788-0404
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43002207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine