Sergio M Zamora MD PLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME75866 Issued in FL

Legal business name

SERGIO M ZAMORA MD PLC

Practice address

1890 Lpga Blvd
Suite 150
Daytona Beach, FL 32117-7130

Phone

(386) 274-5557

Fax

(386) 274-5527

NPI assigned

Aug 20, 2006

Last updated

Sep 8, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sergio M Zamora, MDNPI 1912909805

Title

Sole Member

Phone

(386) 274-5557

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sergio Martin Zamora, MD

  • Plastic Surgery Physician
  • Daytona Beach, FL
  • NPI 1912909805
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1982719043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 150",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177130",
            "telephone_number": "386-274-5557",
            "fax_number": "386-274-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 150",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177130",
            "telephone_number": "386-274-5557",
            "fax_number": "386-274-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGIO M ZAMORA MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "386-274-5557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME75866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "AL989",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Senior Solutions, Inc
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• Serene Sleep Solutions LLC
• Samantha Serle
• Robert A Session Jr.
• Dahlia Shaaban
• April Marie Shadeed, ARNP, FNP-C
• Shady Oaks Rest Home Inc.

• Specialist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.