Individual
MRS. DEBORAH LYNN ZITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C,IBCLC
Contact information
Practice address
2487 DEMERE RD STE 500, ST SIMONS ISLAND, GA 31522-5644
(912) 268-4488
(888) 503-7119
Mailing address
192 DUNBARTON CT, ST SIMONS ISLAND, GA 31522-1013
(912) 638-0782
(912) 554-0344
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
10875901
GA
2080A0000X
Pediatric Adolescent Medicine Physician
002234
GA
363AM0700X
Medical Physician Assistant
Primary
002234
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002234
GA LICENSE
GA
05
—
100001874A
—
GA
Enumeration date
08/18/2006
Last updated
02/01/2022
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