Provider Demographics
NPI:1194992495
Name:ZUKOTYNSKI, ZOFIA SUSAN (MD)
Entity type:Individual
Prefix:DR
First Name:ZOFIA
Middle Name:SUSAN
Last Name:ZUKOTYNSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 NE OCEAN BLVD
Mailing Address - Street 2:UNIT 17
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4359
Mailing Address - Country:US
Mailing Address - Phone:772-334-4777
Mailing Address - Fax:
Practice Address - Street 1:417 SE BALBOA AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2327
Practice Address - Country:US
Practice Address - Phone:772-463-4128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLL610208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice