Individual
DR. PETER MANGONE ZIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 EAST SILVER PALM AVENUE, MELBOURNE, FL 32901-3123
(321) 725-9041
(321) 722-9248
Mailing address
17 EAST SILVER PALM AVENUE, MELBOURNE, FL 32901-3123
(321) 725-9041
(321) 722-9248
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
14855
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139150553743
HUMANA
—
01
—
48587
BCBS
—
01
—
CL1732
RR MEDICARE
—
01
—
D55350
HEALTH FIRST
—
Enumeration date
06/29/2006
Last updated
07/08/2007
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