Provider Demographics
NPI:1487048518
Name:SKILLED PHYSIATRISTS, PA
Entity type:Organization
Organization Name:SKILLED PHYSIATRISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:MANNAN
Authorized Official - Last Name:ZAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-935-2438
Mailing Address - Street 1:5004 E FOWLER AVE
Mailing Address - Street 2:C-214
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5004 E FOWLER AVE
Practice Address - Street 2:C-214
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-2181
Practice Address - Country:US
Practice Address - Phone:630-935-2438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 122061208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty