Provider Demographics
NPI:1346348141
Name:ZITMAN, ROGER I (MD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:I
Last Name:ZITMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13096 103RD AVE. NORTH
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-5608
Mailing Address - Country:US
Mailing Address - Phone:727-593-5269
Mailing Address - Fax:
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:VAMC BAY PINES
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-5008
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-319-1075
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 57180207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology