Provider Demographics
NPI:1932378882
Name:ALEX ZELENKA MD PA
Entity Type:Organization
Organization Name:ALEX ZELENKA MD PA
Other - Org Name:PREMIER INTERNAL MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELENKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:727-641-6840
Mailing Address - Street 1:11321 COUNTRYWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2610
Mailing Address - Country:US
Mailing Address - Phone:813-814-4204
Mailing Address - Fax:813-814-4219
Practice Address - Street 1:11321 COUNTRYWAY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2610
Practice Address - Country:US
Practice Address - Phone:813-814-4204
Practice Address - Fax:813-814-4219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88286207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty