Provider Demographics
NPI:1518302447
Name:ZAWODNIAK, ASHLEY B (DO)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:B
Last Name:ZAWODNIAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 FORTENBERRY ROAD
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952
Mailing Address - Country:US
Mailing Address - Phone:321-492-0390
Mailing Address - Fax:321-386-0743
Practice Address - Street 1:300 FORTENBERRY RD
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3621
Practice Address - Country:US
Practice Address - Phone:321-492-0390
Practice Address - Fax:321-386-0743
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3079207R00000X
FLOS20703207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine