# MIRA ZELIN, DO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417242520
- **Authorized official:** DR. MIRA ZELIN DO (PHYSICIAN)
- **Authorized official phone:** (479) 530-7035

## Contact information

- **Practice address:** 12440 CORTEZ BLVD, BROOKSVILLE, FL 34613-2628
- **Practice address phone:** (479) 601-2314
- **Practice address fax:** (479) 246-9005
- **Mailing address:** PO BOX 12038, BROOKSVILLE, FL 34603-2038
- **Mailing address phone:** (479) 601-2314
- **Mailing address fax:** (479) 246-9005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | OS11859 | FL | Yes |

## Other

- **Enumeration date:** 06/16/2011
- **Last updated:** 10/10/2012