Basic Information
| Provider Information | |||||||||
| NPI: | 1912291725 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SANJEEV ZUTSHI PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SANJEEV ZUTSHI PA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3390 TAMIAMI TRL STE 105 | ||||||||
| Address2: | |||||||||
| City: | PORT CHARLOTTE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339528161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9418835050 | ||||||||
| FaxNumber: | 9418835050 | ||||||||
| Practice Location | |||||||||
| Address1: | 3390 TAMIAMI TRL STE 105 | ||||||||
| Address2: | |||||||||
| City: | PORT CHARLOTTE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339528161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9418835050 | ||||||||
| FaxNumber: | 9418835050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2011 | ||||||||
| LastUpdateDate: | 06/09/2011 | ||||||||
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| AuthorizedOfficialLastName: | ZUTSHI | ||||||||
| AuthorizedOfficialFirstName: | RAKHSHA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9418835050 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.