Provider Demographics
NPI:1518145283
Name:JEFFREY L ZIMM MD PA
Entity type:Organization
Organization Name:JEFFREY L ZIMM MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZIMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-592-5511
Mailing Address - Street 1:1435 IMMOKALEE RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1401
Mailing Address - Country:US
Mailing Address - Phone:239-592-5511
Mailing Address - Fax:239-592-9259
Practice Address - Street 1:1435 IMMOKALEE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1401
Practice Address - Country:US
Practice Address - Phone:239-592-5511
Practice Address - Fax:239-592-9259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34979OtherBCBS
FL34979OtherBCBS
FL3896340001Medicare PIN
FLK1397Medicare PIN
FL3896340001Medicare NSC