Basic Information
| Provider Information | |||||||||
| NPI: | 1548564743 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZHOU | ||||||||
| FirstName: | JUN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14225 EAST FOWLER AVENUE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336172026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139727100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14225 EAST FOWLER AVENUE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336172026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139727100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2011 | ||||||||
| LastUpdateDate: | 08/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | L1818875 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207ZP0102X | ME118348 | FL | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.