Basic Information
| Provider Information | |||||||||
| NPI: | 1447348750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZOLNOUN | ||||||||
| FirstName: | DENNIZ | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2310 60TH STREET CT W | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342096609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417924993 | ||||||||
| FaxNumber: | 9417952905 | ||||||||
| Practice Location | |||||||||
| Address1: | 2310 60TH STREET CT W | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342096609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417924993 | ||||||||
| FaxNumber: | 9417952905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME130636 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 9901089 | NC | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 891231Y | 05 | NC | MEDICAID |