Individual
ALEXANDER ZIMILEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 PRUDENTIAL DR STE 304, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32207-8205
(904) 348-0974
(904) 348-5627
Mailing address
PO BOX 44004, JACKSONVILLE, FL 32231-4004
(904) 202-1032
(904) 348-5627
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME104240
FL
390200000X
Student in an Organized Health Care Education/Training Program
AC0552605053
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001307200
—
FL
01
—
P01377627
RAILROAD MEDICARE
FL
Enumeration date
06/05/2008
Last updated
11/18/2015
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