Provider Demographics
NPI:1386976009
Name:ZAIDI, TAZEEN TAHIR (MD)
Entity type:Individual
Prefix:DR
First Name:TAZEEN
Middle Name:TAHIR
Last Name:ZAIDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAZEEN
Other - Middle Name:
Other - Last Name:TAHIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 952917
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-2917
Mailing Address - Country:US
Mailing Address - Phone:407-402-2303
Mailing Address - Fax:407-321-0461
Practice Address - Street 1:712 W 25TH ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-4232
Practice Address - Country:US
Practice Address - Phone:407-402-2303
Practice Address - Fax:407-321-0461
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48959207Q00000X
OK27139207Q00000X
FLME114284207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHF013ZOtherMEDICARE PTAN
FL117979200Medicaid