Provider Demographics
NPI:1831199983
Name:BERECZKI, ZOLTAN JR (DO)
Entity type:Individual
Prefix:DR
First Name:ZOLTAN
Middle Name:
Last Name:BERECZKI
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1672 SEA BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-2028
Mailing Address - Country:US
Mailing Address - Phone:727-353-3351
Mailing Address - Fax:727-353-3354
Practice Address - Street 1:3001 N ROCKY POINT DR E
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5810
Practice Address - Country:US
Practice Address - Phone:727-353-3351
Practice Address - Fax:727-353-3354
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS011940207X00000X
FLOS9841207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI33346Medicare UPIN