| Michael A Zimmer M D P L C | |
|
509 Jackson St N St Petersburg FL 33705-1477 | |
| (727) 820-7800 | |
| (727) 820-7801 |
| Full Name | Michael A Zimmer M D P L C |
|---|---|
| Speciality | Internal Medicine |
| Location | 509 Jackson St N, St Petersburg, Florida |
| Authorized Official Name and Position | Michael A Zimmer (OWNER) |
| Authorized Official Contact | 7278207800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael A Zimmer M D P L C 509 Jackson St N St Petersburg FL 33705-1477 Ph: (727) 820-7800 | Michael A Zimmer M D P L C 509 Jackson St N St Petersburg FL 33705-1477 Ph: (727) 820-7800 |
| NPI Number | 1558476549 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 04/12/2018 |
| Medicare PECOS PAC ID | 4981601648 |
|---|---|
| Medicare Enrollment ID | O20061023000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558476549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gina R Scaggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043274848 PECOS PAC ID: 1052326527 Enrollment ID: I20060221000114 |
| Provider Name | Michael Zimmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043214950 PECOS PAC ID: 7911904305 Enrollment ID: I20071226000156 |
| Provider Name | Cheryl L Dyrhaug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417241159 PECOS PAC ID: 9739351933 Enrollment ID: I20140422001990 |
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