Provider Demographics
NPI:1265807127
Name:DR. ZAIN BARNOUTI LLC
Entity type:Organization
Organization Name:DR. ZAIN BARNOUTI LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNOUTI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:904-636-9197
Mailing Address - Street 1:9310 OLD KINGS RD S
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6152
Mailing Address - Country:US
Mailing Address - Phone:904-636-9197
Mailing Address - Fax:
Practice Address - Street 1:9310 OLD KINGS RD S
Practice Address - Street 2:SUITE 1201
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6152
Practice Address - Country:US
Practice Address - Phone:904-636-9197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3735213EP1101X, 213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty