Provider Demographics
NPI:1548061682
Name:INFECTIOUS DISEASE DOCTOR
Entity type:Organization
Organization Name:INFECTIOUS DISEASE DOCTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVASKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-526-2311
Mailing Address - Street 1:400 MOULTRIE LANDING UNIT 9205
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6184
Mailing Address - Country:US
Mailing Address - Phone:904-547-2808
Mailing Address - Fax:904-679-3169
Practice Address - Street 1:400 HEALTHCARE BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-0400
Practice Address - Country:US
Practice Address - Phone:904-547-2808
Practice Address - Fax:904-679-3169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty