Provider Demographics
NPI:1790665032
Name:ZEKA, ERGYS
Entity type:Individual
Prefix:
First Name:ERGYS
Middle Name:
Last Name:ZEKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2879 THAXTON DR APT 60
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-4750
Mailing Address - Country:US
Mailing Address - Phone:586-822-9171
Mailing Address - Fax:
Practice Address - Street 1:2879 THAXTON DR APT 60
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4750
Practice Address - Country:US
Practice Address - Phone:586-822-9171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11042076363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty