Provider Demographics
NPI:1396908588
Name:ZANN, KASEY LEE (OD)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:LEE
Last Name:ZANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 DAY AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-5108
Mailing Address - Country:US
Mailing Address - Phone:319-389-1343
Mailing Address - Fax:
Practice Address - Street 1:1201 NW 17TH ST
Practice Address - Street 2:MIAMI VAMC, SURGICAL SERVICE, OPHTHALMOLOGY
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-575-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002406152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist