Basic Information
Provider Information
NPI: 1477558914
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZUBER
FirstName: AMY
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 10744
Address2:  
City: CLEARWATER
State: FL
PostalCode: 337578744
CountryCode: US
TelephoneNumber: 7275320002
FaxNumber: 7272664928
Practice Location
Address1: 12780 RACE TRACK RD
Address2: STE 300
City: TAMPA
State: FL
PostalCode: 336261395
CountryCode: US
TelephoneNumber: 8137929541
FaxNumber: 8139263409
Other Information
ProviderEnumerationDate: 06/20/2005
LastUpdateDate: 02/24/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XOS8913FLY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
26733980005FL MEDICAID


Home