Organization
ZACHARIS MEDICAL CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODOSSIS ZACHARIS MD (OWNER)
(386) 423-0505
Entity
Organization
Contact information
Practice address
1055 N DIXIE FWY, SUITE 1, NEW SMYRNA BEACH, FL 32168-6201
(386) 423-0505
(386) 423-0515
Mailing address
1055 N DIXIE FWY, SUITE 1, NEW SMYRNA BEACH, FL 32168-6201
(386) 423-0505
(386) 423-0515
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME95732
MEDICAL LICENSE
FL
Enumeration date
03/08/2017
Last updated
03/08/2017
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